Complications of laparoscopic-assisted vaginal hysterectomy.

Laparoscopic-assisted vaginal hysterectomy is now an accepted procedure and is being performed by increasingly large numbers of gynecologic surgeons. The procedure is technically difficult and has the potential for serious complications. Sixty-two laparoscopic hysterectomies were performed by the senior author from June 15, 1991, to December 15, 1993.

Argon Assisted CO2 Laser Laparoscopy.

The use of a small amount of Argon gas to purge the operating channel of the CO2 laser laparoscope eliminates the thermal lensing (blooming) that has plagued CO2 laser laparoscopy. By eliminating the blooming, the power density and transmission of laser power is increased. Overall, the efficacy of the CO2 laser/laparoscope system is dramatically improved.

A comparison of laparoscopically assisted vaginal hysterectomy vs traditional total abdominal and vaginal hysterectomies.

The objective of this work was to compare laparoscopically assisted vaginal hysterectomy to traditional total abdominal and vaginal hysterectomies in seven critical areas: anesthesia time, surgery time, hospital stay, operative blood loss, total analgesic use, time required to return to work, and total cost of each of these procedures. The first 25 unscreened, consecutive laparoscopically assisted vaginal hysterectomies performed by the senior author were compared with 25 randomly selected traditional total abdominal and 25 randomly selected vaginal hysterectomies performed by the senior author's professional corporation. Laparoscopically assisted vaginal hysterectomy compared favorably to abdominal and vaginal hysterectomy in three areas and was superior to both total abdominal hysterectomy and vaginal hysterectomy in the remaining four areas.

The treatment of endometriosis at laparoscopy for infertility.

Endometriosis is found in some infertile women, and treatment by laparotomy and/or hormonal therapy is associated with subsequent pregnancy. In this study, 100 consecutive patients with mild/moderate endometriosis were treated at laparoscopy. Forty of these women achieved a pregnancy within 37 months postoperatively; 73% of these pregnancies occurred within 6 months, and 88% within 12 months of operation.