Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Vol. (33) No. (2) 2011

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1 2011 (2) (33) _ Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Vol. (33) No. (2) 2011 * (2011 / 4 / / 1 / 18 ) (26) 2011/1/8 2010/9/9 : (6) (12) (8) (13) (13). : - (6) - / / / / / /. ( %61.5 ).... :,, :. - * 9

2 2011 (2) (33) _ Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Vol. (33) No. (2) 2011 Laparoscopic Hysterectomy Dr. Ahmad Abdul Rahman * (Received 18 / 1 / Accepted 10 / 4 / 2011) ABSTRACT Our study includes 26 patients of the accepted patients at ELSHATBY University Hospital, Alexandria University, Egyptian Arab Republic over the period spanning from 9/9/2010 to 8/1/2011; where they had Laparoscopic Hysterectomy Operations as follows: 6 cases of Laparoscopic sub total hysterectomy 12 cases of Vaginal assisted laparoscopic hysterectomy 8 cases of Laparoscopic total hysterectomy We have performed half of the operations (13 cases) using Bipolar Coagulation, and the other half (13 cases) using Ultracision Harmonic Scalpel. To cut the uterus body from the cervices in laparoscopic sub total hysterectomy cases, which are (6 cases), we used: (two cases) the Loop Bipolar Coagulation (two cases) Ultracision Harmonic Scalpel (two cases) The common cause of hysterectomy was myoma (61.5%) Conclusions: Using cervical loop decreased the time of cutting the uterus body from the cervices and reduced bleeding. Using Ultracision Harmonic Scalpel decreased the time of operation Vaginal assisted laparoscopic hysterectomy was the easiest way Complications were little and insignificant - Keywords: Laparoscopy, Total Hysterectomy, Sub-Total Hysterectomy * Professor; Department of Obstetrics and Gynecology, Faculty of Medicine, Tishreen University, Lattakia, Syria. 10

3 Tishreen University Journal. Health Sciences Series 2011 (2) (33) : %75.[1] 1989 Reich %25 [2], [3] [5]. [4] [7,6].[9,4]. [8] :.., :, (Bipolar Coagulation)..( Ultracision Harmonic Scalpel ) /26/ 2010/9/9 2011/1/8 / 12/. : - : - Storz SCB Unidrive Gyn

4 - Storz Electronic Endoflator Storz Electronic Laparoflator Storz Xenon Nova Storz Karl Storz Endoskope SCB Tricam SL II Sporo 230 Xenon 300w - Sporo 167 1cc D - KLS Martin ME MB1 - Ultracision Harmonic Scalpel Generator 300 Ethicon endo-surgery GEN 04 Veress Needle ڥ :, ( 10 ) ( 5 ) ( 5 ) ( 5 ) morcellator. 30 Cefotaxim ( 3.2 ± 44.7) (1) : : %23 %46.2 %30.8 % (%46.2) (1). %19.2 %3.8 (2)

5 Tishreen University Journal. Health Sciences Series 2011 (2) (33) %19.2 (2).. : ) Cervical Loop Monopolar ( 1.5. ( ). Bipolar. Ultracision Harmonic Scalpel (3) ( ) 0.23 ± 2.3 (Cervical Loop) 1.7 ± Bipolar 1.2 ± 14.7 Ultracision Harmonic Scalpel. (3) (4) %15.14 %3.8 % II I %26.9 (4). %26.9 %3.8. (5) 7 1 %26.9 (5). (6) %61.5 %11.5 %27 % II I 13

6 .(%61.5) (6). (7) Ultracision Harmonic Bipolar Scalpel % % % % % % %50 13 %50 13 Bipolar (%50) (7).Ultracision Harmonic Scalpel (8) Ultracision Harmonic Bipolar Scalpel 19.4 ± ± ±127.7 Ultracision Harmonic Scalpel 20.8 ± ± ± Bipolar (8). %11.5 %15.4 %11.5 %7.7 (9) (Morcellator ) ڥ. (9) / 4/. 3.3 ± ± ± 24 14

7 Tishreen University Journal. Health Sciences Series 2011 (2) (33) : -. %23,. (Loop) %46.2. ( Cervical Loop ) ( ) Monopolar Bipolar. Bipolar Ultracision Harmonic Scalpel. Ultracision Harmonic Scalpel. Bipolar. : :.. (Loop)... ( Ultracision Harmonic Scalpel. Loop ) :.. 15

8 : 1- HULKA, J.F.; LEVY, B.S.; PARKER, W.H.; et.al. Laparoscopic Assisted vaginal hysterectomy : American Assosiation of Gynecologyic laparoscopists, 1995 Membership survey. J A m Assoc Gynecol Laparoscop 4, 1997, DANIELL, J. F. Endometrial ablation. In AZZIZ R, MURPHY AA(eds): Practical Manual of operative laparoscopy and Hysteroscopy,ed2. New York, Springer, 1997, DE MEEUS, J.B. ; MAGNIN, G. Indications for indications hysterectomy. Eur obstet Gynecol reprod boil 74, 1997, EINARSSON, J. I.; SUZUKI, Y. Total Laparoscopic Hysterectomy,10 Steps Toward a Successful Journal List, Rev Obstet.Gynecol. Winter 2,1, 2009, BOLGER, B.S.; DE BASSOR LOPES A,LAVIE OD,et la : comparison of laparoscopic assisted raolical vaginal hysterectomy in the treatment of early stage cervical carcinoma {abstract}. Gynecol oncol 68, 1998, WILLIS, S. F.; BARTON, D. ; THOMAS, EJ Ind. Laparoscopic Hysterectomy with or without Pelvic Lymphadenectomy or Sampling in a high risk series of patients with endometrial cancer International seminars in surgical oncology, Vol. 3, SPIRTOS, N.M.; BALLON, S.C.; PEREZ, G.M.et la : Laparoscopic Radical Hysterectomy (Type III ) with aortic and pelvic. Lymphadenectomy : surgical. morlidity and short term follow up {abstract}. Gynecol oncol 68, 1998, WALID,M.SAMI ; HEATON, RICHARD, L. Total Laparoscopic Hysterectomy for uteri over one kilogram, Journal of the Society of Laparoscopic Surgeons, Volume 14, Number 2, April June 2010, (5) 9- SIREN, P.H.; KURTEI, T. A Nationnide Analysis of Laparoscopic Complications. Obstet. Gynecol 98, 1997,