Laparoscopic Surgery and Common Surgical Techniques in Hysterectomy

 

A Common Surgical Techniques

Hysterectomy is one of the most common surgical techniques used to treat benign uterine diseases. Around 4,077 elective hysterectomies and 207 emergency hysterectomies were performed, which represents 5.8 and 0.9% respectively of the major operations performed in general and clinical-surgical hospitals. During their internship in laparoscopic technique many of them have not received practical training with simulators Laparoscopic Trainer Box.

It is the second worldwide cause of procedures major surgical procedures performed on women. More than 600,000 cases are reported each year. In Spain this figure is lower, although it exceeds 150 cases per 100,000 women per year and it is one of the 15 most performed hospital procedures. The highest number of hysterectomies is in the age group 40 to 44 years.

Minimum access surgery for the treatment of gynecological diseases was performed in 3.6% of all gynecological operations and 12.9% of all minimum access operations, and an increase was observed in in 2011 with the performance of 5,348 gynecological procedures in this way.

Three Approaches to Hysterectomy

There are three approaches to hysterectomy for curing disease:

1. Abdominal Hysterectomy

2. Vaginal Hysterectomy

3. Laparoscopic Hysterectomy

The objective of laparoscopic hysterectomy is to convert an abdominal hysterectomy into a vaginal one, selecting each case properly and without forgetting the classic patterns.

Some of Its Benefits Are:

Better approach with smaller incisions, a lower intraoperative blood loss and a reduction in the fall of the hemoglobin level, reduction of hospital stay, faster return to daily activities, fewer wound or wound infections. abdominal wall, less immune damage, less incidence of hernias. At the price of a longer surgical time and more injuries to the urinary tract. The biggest of these is that an abdominal incision that typically requires further hospitalization and recovery is avoided.

Postoperative pain is less, presumably due to less tissue damage and a reduction in the inflammatory response. In this sense, several investigations support the fact that laparoscopic techniques reduce hospital stay and recovery is faster. We must also not forget the aesthetic factor, since micro-incisions are made.

Benefits of Laparoscopic Hysterectomy

Better approach with smaller incisions, less intraoperative blood loss and a reduction in the fall of the hemoglobin level, reduced hospital stay, faster return to daily activities, fewer wound infections or of the abdominal wall, less immune damage, less incidence of hernias, at the price of a longer surgical time and more lesions of the urinary tract.

This review is carried out with the objective of summarizing updated information on laparoscopic hysterectomy, the criteria that are considered more important for its indications are exposed and the advantages of the procedure are evaluated, so that it can serve as teaching material for residents of surgical specialties who practice said intervention.

Laparoscopic Hysterectomy

Historical data and evolution

The first to perform both diagnostic and therapeutic procedures through the cavities was the Greek Hippocrates of Kos. It is said that he used cannulas to explore inside the mouth and anus; He would have even managed to treat intestinal obstructions through the insufflation of air with those instruments. Abucasis was one of the most renowned surgeons of his time, he was the first to introduce a tube into the vagina, illuminate it and study the cervix. Built an instrument to visualize the organs by directing light into the body, a forerunner of modern endoscopy he called it lichtleiter.

Developed the endoscope and perfected it with a system of lenses and mirrors and studied the bladder, cervix and uterus with this instrument. Penteleoni used this endoscope to remove a tumor from the uterus. started the use of an air insufflator in 1901, this filtered through cotton, in order to distend the abdominal cavity to stop bleeding through the pneumoperitoneum. Which was later used to achieve better vision during these procedures. Veress perfected a puncture needle designed in previous years, a gynecologist by profession, describes Trendelenburg's position for gynecological examination.

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