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Human Reproduction, Vol. 11, No. 10, pp. 2122-2126, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Surgery: Hysterectomy for patients without previous vaginal delivery: results and modalities of laparoscopic surgery

Charles Chapron1, Jean-Bernard Dubuisson and Yann Ansquer

Service de Chirurgie Gynecologique (Pr Dubuisson), Clinique Universitaire Baudelocque C.H.U. Cochin Port-Royal, 123, Boulevard Port-Royal, 75014 Pans, France

Correspondence: 1To whom correspondence should be addressed

The great majority of hysterectomies in nulliparous patients have been carried out via laparotomy. The purpose of this study was to establish whether laparoscopic surgery can be of use in an attempt to reduce the number of iaparotomies when hysterectomy is indicated in patients without previous vaginal delivery. A retrospective study was carried out on 66 women who had not had a previous vaginal delivery who underwent hysterectomy from January 1993 to May 1995. Laparotomy was required for only 19.7% of cases (13 patients). For the 53 patients (80.3%) who underwent laparoscopic hysterectomy, the average duration of the operation was 152.24±45.7 min, and the average weight of the uterus was 2383±154.1 g. The duration of the laparoscopic operation was correlated in a statistically significant fashion with the weight of the uterus (P=0.0005), the necessity of associated procedures during the hysterectomy (P=0.01) and the surgeon's experience (P=0.01). These results demonstrate that laparoscopic surgery decreases the number of laparotomies necessary for patients with no previous vaginal delivery who require hysterectomy. When vaginal access is poor, simple laparoscopic preparation is inadequate and the only possibility of avoiding laparotomy is to carry out the hysterectomy entirely via the laparoscopic route.

Key words: hysterectomy/nulliparous patients/operative laparo-scopy/total laparoscopic hysterectomy


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C. Chapron, L. Laforest, Y. Ansquer, A. Fauconnier, B. Fernandez, G. Breart, and J.-B. Dubuisson
Hysterectomy techniques used for benign pathologies: results of a French multicentre study
Hum. Reprod., October 1, 1999; 14(10): 2464 - 2470.
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