Laparoscopic approach to hysterectomy

Hakan Nazik



Modern laparoscopic surgery is widely used throughout the world as it offers greater advantages than open procedures. The laparoscopic approach to hysterectomy has evolved over the last 20 years. Hysterectomies are performed abdominally, vaginally, laparoscopically or, more recently, with robotic assistance. Indications for a total laparoscopic hysterectomy are similar to those for total abdominal hysterectomy, and most commonly include uterine leiomyomata, pelvic organ prolapse, and abnormal uterine bleeding. When hysterectomy is going to be performed, the surgeon should decide which method is safer and more cost-effective. This paper aims to make a review of the indications, techniques and advantages of laparoscopic hysterectomy as well as the criteria to be used for appropriate patient selection.


Laparoscopic hysterectomy, Indications, Technique, Complication

Full Text



  • Merrill RM. Hysterectomy surveillance in the United States, 1997-2005. Med Sci Monit 2008; 14: 24-31
  • Semm K. Endoscopic methods in gastroenterology and gynecology. Completion of diagnostic pelviscopy by endoscopic abdominal surgery. Fortschr Med 1984; 102: 534-7
  • Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg 1989; 5: 213;
  • Johns DA. Laparoscopic Assisted Vaginal Hysterectomy. In: Sutton CJG, Diamond MP (Eds.). Endoscopic Surgery for Gynaecologists, 2nd Ed. London: WB Saunders, 1998; p. 300
  • Garry R, Reich H. Basic techniques for advanced laparoscopic surgery. In: Garry R, Reich H (Eds). Laparoscopic Hysterectomy. Oxford: Blackwell Scientific, 1992; p. 46
  • ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol 2009; 114: 1156;
  • Johnson N, Barlo, D, Lethaby A, et al. Methods of hysterectomy: systematic review and metha-analysis of randomized controlled trials. BMJ 2005; 330: 1478;
  • American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Number 311, April 2005. Appropriate use of laparoscopically assisted vaginal hysterectomy. Obstet Gynecol 2005; 105: 929
  • Tozzi R, Malur S, Koehler C, et al. Analysis of morbidity in patients with endometrial cancer: is there a commitment to offer laparoscopy? Gynecol Oncol 2005; 97: 4-9;
  • Ribeiro SC, Ribeiro RM, Santos NC, et al. A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynaecol Obstet 2003; 83: 37-43;
  • Pelosi MA 2nd, Pelosi MA 3rd. Pelosi minilaparotomy hysterectomy: a non-endoscopic minimally invasive alternative to laparoscopy and laparotomy. Surg Technol Int 2004; 13: 57-167
  • Sheth S. Vaginal or abdominal hysterectomy. In: Sheth S, Sutton CJG (Eds). Menorrhagia. Oxford: Isis Medical Media, 1999; p. 213
  • Reich, H. Advanced laparoscopic techniques. In: Sutton, CJG, Diamond, MP (Eds). Endoscopic Surgery for Gynaecologists, 2nd ed. London: WB Saunders, 1998; p. 54
  • Kho RM, Hilger WS, Hentz JG, et al. Robotic hysterectomy: technique and initial outcomes. Am J Obstet Gynecol 2007; 197: 113.e1-4
  • Beste TM, Nelson KH, Daucher JA. Total laparoscopic hysterectomy utilizing a robotic surgical system. JSLS 2005; 9: 13-5
  • Fanfani F, Fagotti A, Scambia G. Laparoendoscopic single-site surgery for total hysterectomy. Int J Gynaecol Obstet 2010; 109: 76-7;
  • Possover M, Krause N, Plaul K, et al. Laparoscopic para-aortic and pelvic lymphadenectomy: experience with 150 patients and review of the literature. Gynecol Oncol 1998; 71: 19-28;
  • Altgassen C, Michels W, Schneider A. Learning laparoscopic-assisted hysterectomy. Obstet Gynecol 2004; 104: 308;
  • Wattiez A, Cohen SB, Selvaggi L. Laparoscopic hysterectomy. Curr Opin Obstet Gynecol 2002; 14: 417-22;
  • Winer WK, Lyons TL. Suggested set-up and layout of instruments and equipment for advanced operative laparoscopy. J Am Assoc Gynecol Laparosc 1995; 2: 231-4;
  • Lyons T, Falcone T, Falk SJ. Laparoscopic approach to hysterectomy. Available at: Last accessed december, 2012
  • Massarweh NN, Cosgriff N, Slakey DP. Electrosurgery: history, principles, and current and future uses. J Am Coll Surg 2006; 202: 520-30;
  • Tucker RD. Laparoscopic electrosurgical injuries: survey results and their implications. Surg Laparosc Endosc 1995; 5: 311-7
  • Nazik H, Bodur S, Api M, et al. Glutaraldehyde-induced bowel injury during gynecologic laparoscopy. J Minim Invasive Gynecol 2012; 19: 756-7;
  • Sutton PA, Awad S, Perkins AC, et al. Comparison of lateral thermal spread using monopolar and bipolar diathermy, the Harmonic Scalpel and the Ligasure. Br J Surg 2010; 97: 428-33;
  • Erian J, El-Toukhy T, Chandakas S, et al. One hundred cases of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems. J Minim Invasive Gynecol 2005; 12: 365-9;
  • Ahmad G, Duffy JM, Phillips K, et al. Laparoscopic entry techniques. Cochrane Database Syst Rev 2008; (2): CD006583; doi: 10.1002/14651858.CD006583
  • McCall ML. Posterior culdeplasty; surgical correction of enterocele during vaginal hysterectomy; a preliminary report. Obstet Gynecol 1957; 10: 595;
  • Makai G, Isaacson K. Complications of gynecologic laparoscopy. Clin Obstet Gynecol 2009; 53: 401-11;
  • Magrina JF. Complications of laparoscopic surgery. Clin Obstet Gynecol 2002; 12: 16-24


Abstract: 1327 views
HTML: 4271 views
PDF: 405 views


  • There are currently no refbacks.

© SEEd srl