A new approach to simplify surgical colpotomy in laparoscopic hysterectomy

New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and d...

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Autores principales: van den Haak, L., Rhemrev, J. P. T., Blikkendaal, M. D., Luteijn, A. C. M., van den Dobbelsteen, J. J., Driessen, S. R. C., Jansen, F. W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753248/
https://www.ncbi.nlm.nih.gov/pubmed/26918004
http://dx.doi.org/10.1007/s10397-015-0929-x
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author van den Haak, L.
Rhemrev, J. P. T.
Blikkendaal, M. D.
Luteijn, A. C. M.
van den Dobbelsteen, J. J.
Driessen, S. R. C.
Jansen, F. W.
author_facet van den Haak, L.
Rhemrev, J. P. T.
Blikkendaal, M. D.
Luteijn, A. C. M.
van den Dobbelsteen, J. J.
Driessen, S. R. C.
Jansen, F. W.
author_sort van den Haak, L.
collection PubMed
description New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and duration. Furthermore, it proposes an alternative route that may simplify this step in laparoscopic hysterectomy. A structured interview, a prospective cohort study, and a problem analysis were performed regarding experienced difficulty and duration of surgical colpotomy in laparoscopic hysterectomy. Sixteen experts in minimally invasive gynecologic surgery from 12 hospitals participated in the structured interview using a 5-point Likert scale. The colpotomy in LH received the highest scores for complexity (2.8 ± 1.2), compared to AH and VH. Colpotomy in LH was estimated as more difficult than in AH (2.8 vs 1.4, p < .001). In the cohort study, 107 patients undergoing LH were included. Sixteen percent of the total procedure time was spent on colpotomy (SD 7.8 %). BMI was positively correlated with colpotomy time, even after correcting for longer operation time. No relation was found between colpotomy time and blood loss or uterine weight. The surgical colpotomy step in laparoscopic hysterectomy should be simplified as this study demonstrates that it is time consuming and is considered to be more difficult than in other hysterectomy procedures. A vaginal approach to the colpotomy is proposed to achieve this simplification.
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spelling pubmed-47532482016-02-23 A new approach to simplify surgical colpotomy in laparoscopic hysterectomy van den Haak, L. Rhemrev, J. P. T. Blikkendaal, M. D. Luteijn, A. C. M. van den Dobbelsteen, J. J. Driessen, S. R. C. Jansen, F. W. Gynecol Surg Original Article New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and duration. Furthermore, it proposes an alternative route that may simplify this step in laparoscopic hysterectomy. A structured interview, a prospective cohort study, and a problem analysis were performed regarding experienced difficulty and duration of surgical colpotomy in laparoscopic hysterectomy. Sixteen experts in minimally invasive gynecologic surgery from 12 hospitals participated in the structured interview using a 5-point Likert scale. The colpotomy in LH received the highest scores for complexity (2.8 ± 1.2), compared to AH and VH. Colpotomy in LH was estimated as more difficult than in AH (2.8 vs 1.4, p < .001). In the cohort study, 107 patients undergoing LH were included. Sixteen percent of the total procedure time was spent on colpotomy (SD 7.8 %). BMI was positively correlated with colpotomy time, even after correcting for longer operation time. No relation was found between colpotomy time and blood loss or uterine weight. The surgical colpotomy step in laparoscopic hysterectomy should be simplified as this study demonstrates that it is time consuming and is considered to be more difficult than in other hysterectomy procedures. A vaginal approach to the colpotomy is proposed to achieve this simplification. Springer Berlin Heidelberg 2016-01-12 2016 /pmc/articles/PMC4753248/ /pubmed/26918004 http://dx.doi.org/10.1007/s10397-015-0929-x Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
van den Haak, L.
Rhemrev, J. P. T.
Blikkendaal, M. D.
Luteijn, A. C. M.
van den Dobbelsteen, J. J.
Driessen, S. R. C.
Jansen, F. W.
A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title_full A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title_fullStr A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title_full_unstemmed A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title_short A new approach to simplify surgical colpotomy in laparoscopic hysterectomy
title_sort new approach to simplify surgical colpotomy in laparoscopic hysterectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753248/
https://www.ncbi.nlm.nih.gov/pubmed/26918004
http://dx.doi.org/10.1007/s10397-015-0929-x
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