A modified LAVH to reduce urinary tract injuries: 102 consecutive case-series at Srinagarind Hospital, Khon Kaen University.

Objective: To describe the technique and results of modified laparoscopically assisted vaginal hysterectomy (LAVH), especially, on the urinary tract injury.

Material And Method: One hundred two patients scheduled for modified LAVH between November 2007 and December 2010 were enrolled.

Results: The majority of patients were middle-aged. The median parity was two; 16 patients were nulliparous. Among the 39 patients who had undergone prior abdominal or pelvic surgeries, eight had a prior cesarean delivery. The majority of LAVH indication was leiomyoma with complications. The median uterine weight was 300 g (range 120 to 1,450 g). The median operating time was 105 min (range 50 to 365 min). One patient had repeated laparoscopic uterine artery electrocoagulation 12 hours after surgery. Two patients were re-admitted with pelvic inflammatory disease (PID) two to three weeks post-operatively. No bowel or urinary tract injuries were detected during intra- and post-operation.

Conclusion: The modified LAVH presented here was a technique that showed a low incidence of urinary tract injury.