Study: total laparoscopic hysterectomy safe alternative to abdominal approach. (Benign Uterine Disease).

SCOTTSDALE, ARIZ. -- Total laparoscopic hysterectomy can be a safe and effective alternative to abdominal hysterectomy in patients with benign uterine disease who are not candidates for vaginal hysterectomy Dr. David J. Levine said.

On the basis of the results of 256 laparoscopic hysterectomies that he performed from 1996 through 2001, he predicted that "the versatility of this procedure is going to decrease the incidence of total abdominal hysterectomy."

Dr. Levine performed the laparoscopic surgeries for a variety of indications, including menorrhagia, endometriosis, cervical dysplasia, fibroids, and prolapse. "You may ask, 'Why do a total laparoscopic hysterectomy for prolapse instead of a vaginal hysterectomy?' In my hands, I feel like I can suspend the vaginal cuff much better when I'm operating laparoscopically than when I'm operating vaginally" he said at an international congress on uterine fibroids sponsored by the American Association of Gynecologic Laparoscopists.

The laparoscopic approach was especially useful in the 29% of patients who were nulliparous or had given birth only by C-section, which limited vaginal access to the uterus, said Dr. Levine, director of gynecologic laparoscopy and of ...