Rational type of laparoscopic hysterectomy and safety in anesthetic profiles

Abstract

Objective: To evaluate what type of surgery would be more reasonable among 3 types of laparoscopic hysterectomy and to evaluate the safety of cardio-pulmonary changes on these patients during these operations. Method: A retrospective study was carried out in 215 women who underwent laparoscopic hysterectomy including laparoscopic-assisted vaginal hysterectomy (LAVH), laparoscopic hysterectomy (LH), total laparoscopic hysterectomy (TLH). Blood gas analysis, end-tidal CO2 levels and vital signs were checked and compared with control and preceding values. Results: The average duration of operation was 102.5 min, 83.8 min and 118.3 min for LAVH (n = 97), LH (n = 75) and TLH (n = 43), respectively (p < 0.05). The average amount of bleeding was 297.5 ml, 152.3 ml and 149.2 ml for each type of hysterectomy, respectively. Hemoglobin decreased by an average of 1.6 g/100 ml, 0.9 g/100 ml and 0.8 g/100 ml, respectively. There was a lesser amount of bleeding for LH and TLH than for LAVH (p < 0.05). Profiles of blood gas analysis and expiratory CO2 varied significantly according to the operative stages under controlled anesthesia (p < 0.05), but were within the normal range. Conclusion: These results demonstrate that laparoscopic procedures advancing below the uterine vasculature can be considered effective for hysterctomies and that proper anesthesia can safely control the cardio-pulmonary changes during laparoscopic hysterectomy.