The Experts below are selected from a list of 39639 Experts worldwide ranked by ideXlab platform
Edward J Mascha - One of the best experts on this subject based on the ideXlab platform.
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prospective randomized clinical trial of laparoscopically assisted vaginal Hysterectomy versus total abdominal Hysterectomy
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Tommaso Falcone, Marie Fidela R Paraiso, Edward J MaschaAbstract:Abstract Objective: We compared operative time, length of hospital stay, postoperative recovery, return to work, and costs for women undergoing laparoscopically assisted vaginal Hysterectomy or abdominal Hysterectomy. Study Design: A prospective randomized clinical trial of laparoscopically assisted vaginal Hysterectomy (n = 24) versus abdominal Hysterectomy (n = 24) was carried out in a tertiary care setting. The main outcome variables were operative time, length of hospital stay, and return to work. Secondary outcomes were postoperative pain and return to normal activity as determined by weekly visual analog scales and daily diary. Hospital costs were calculated. Results: The laparoscopically assisted vaginal Hysterectomy group had longer operative times (median and quartiles, laparoscopically assisted vaginal Hysterectomy 180 [139, 225] minutes vs abdominal Hysterectomy 130 [97, 155] minutes), lower requirements for postoperative intravenous analgesia (patient-controlled analgesia pump, median and quartiles: laparoscopically assisted vaginal Hysterectomy 22.1 [15.9, 23.5] hours, abdominal Hysterectomy 36.7 [26.2, 45.0] hours), shorter length of hospital stay (median and quartiles, laparoscopically assisted vaginal Hysterectomy 1.5 [1.0, 2.3] days, abdominal Hysterectomy 2.5 [1.5, 2.5] days), and quicker return to work (Kaplan-Meier analysis, P = .03). Both procedures had similar hospital costs ( P = .21). Conclusion: Laparoscopically assisted vaginal Hysterectomy appears to allow patients a more rapid postoperative recovery and an earlier return to work with hospital costs similar to those of abdominal Hysterectomy. (Am J Obstet Gynecol 1999;180:955-62.)
Robert L Summitt - One of the best experts on this subject based on the ideXlab platform.
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a multicenter randomized comparison of laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy in abdominal Hysterectomy candidates
Obstetrics & Gynecology, 1998Co-Authors: Robert L Summitt, Thomas G Stovall, John F Steege, Gary H LipscombAbstract:Abstract Objective: To compare intraoperative and postoperative outcomes between laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy among patients who are not eligible for vaginal Hysterectomy. Methods: Study subjects were randomly assigned to undergo laparoscopically assisted vaginal Hysterectomy or standard abdominal Hysterectomy. Intraoperative and postoperative management was similar for each group. Surgical characteristics, complications, length of hospital stay, charges, and convalescence were analyzed. Results: Sixty-five women at three institutions underwent laparoscopically assisted vaginal Hysterectomy (n = 34) or abdominal Hysterectomy (n = 31). Three patients in the laparoscopic group required conversion to abdominal Hysterectomy. Mean operating time was significantly longer for laparoscopically assisted vaginal Hysterectomy (179.8 versus 146.0 minutes). There were no differences in blood loss or incidence of intraoperative complications. There was a higher incidence of wound complications in the abdominal Hysterectomy group, but no significant difference in the frequency of postoperative complications. Laparoscopically assisted vaginal Hysterectomy required a significantly shorter mean hospital stay (2.1 days) and convalescence (28.0 days) than abdominal Hysterectomy (4.1 days and 38.0 days, respectively). There were no significant differences in mean hospital charges between the study groups (laparoscopic $8161, abdominal $6974). Conclusion: Except for operating time, there are no differences between laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy regarding intraoperative characteristics among abdominal Hysterectomy candidates. Postoperatively, laparoscopically assisted vaginal Hysterectomy requires a shorter hospital stay and convalescence. Hospital charges are similar between the procedures. A larger number of cases will help determine the indications for laparoscopically assisted vaginal Hysterectomy.
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randomized comparison of laparoscopy assisted vaginal Hysterectomy with standard vaginal Hysterectomy in an outpatient setting
Obstetrics & Gynecology, 1993Co-Authors: Robert L Summitt, Thomas G Stovall, Gary H Lipscomb, Frank W LingAbstract:Objective: To compare outpatient laparoscopy-assisted vaginal Hysterectomy with standard outpatient vaginal Hysterectomy. Methods: Fifty-six women scheduled for vaginal Hysterectomy were randomly assigned to undergo either a laparoscopy-assisted vaginal Hysterectomy with endoscopic staples (N=29) or a standard vaginal Hysterectomy (N=27). There were no differences between the study groups with regard to age, gravidity, parity, preoperative indications, and previous operations. Results: Twenty-eight of 29 laparoscopy-assisted vaginal hysterectomies and all 27 vaginal hysterectomies were completed without incident
Gary H Lipscomb - One of the best experts on this subject based on the ideXlab platform.
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a multicenter randomized comparison of laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy in abdominal Hysterectomy candidates
Obstetrics & Gynecology, 1998Co-Authors: Robert L Summitt, Thomas G Stovall, John F Steege, Gary H LipscombAbstract:Abstract Objective: To compare intraoperative and postoperative outcomes between laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy among patients who are not eligible for vaginal Hysterectomy. Methods: Study subjects were randomly assigned to undergo laparoscopically assisted vaginal Hysterectomy or standard abdominal Hysterectomy. Intraoperative and postoperative management was similar for each group. Surgical characteristics, complications, length of hospital stay, charges, and convalescence were analyzed. Results: Sixty-five women at three institutions underwent laparoscopically assisted vaginal Hysterectomy (n = 34) or abdominal Hysterectomy (n = 31). Three patients in the laparoscopic group required conversion to abdominal Hysterectomy. Mean operating time was significantly longer for laparoscopically assisted vaginal Hysterectomy (179.8 versus 146.0 minutes). There were no differences in blood loss or incidence of intraoperative complications. There was a higher incidence of wound complications in the abdominal Hysterectomy group, but no significant difference in the frequency of postoperative complications. Laparoscopically assisted vaginal Hysterectomy required a significantly shorter mean hospital stay (2.1 days) and convalescence (28.0 days) than abdominal Hysterectomy (4.1 days and 38.0 days, respectively). There were no significant differences in mean hospital charges between the study groups (laparoscopic $8161, abdominal $6974). Conclusion: Except for operating time, there are no differences between laparoscopically assisted vaginal Hysterectomy and abdominal Hysterectomy regarding intraoperative characteristics among abdominal Hysterectomy candidates. Postoperatively, laparoscopically assisted vaginal Hysterectomy requires a shorter hospital stay and convalescence. Hospital charges are similar between the procedures. A larger number of cases will help determine the indications for laparoscopically assisted vaginal Hysterectomy.
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randomized comparison of laparoscopy assisted vaginal Hysterectomy with standard vaginal Hysterectomy in an outpatient setting
Obstetrics & Gynecology, 1993Co-Authors: Robert L Summitt, Thomas G Stovall, Gary H Lipscomb, Frank W LingAbstract:Objective: To compare outpatient laparoscopy-assisted vaginal Hysterectomy with standard outpatient vaginal Hysterectomy. Methods: Fifty-six women scheduled for vaginal Hysterectomy were randomly assigned to undergo either a laparoscopy-assisted vaginal Hysterectomy with endoscopic staples (N=29) or a standard vaginal Hysterectomy (N=27). There were no differences between the study groups with regard to age, gravidity, parity, preoperative indications, and previous operations. Results: Twenty-eight of 29 laparoscopy-assisted vaginal hysterectomies and all 27 vaginal hysterectomies were completed without incident
Miriam Orleans - One of the best experts on this subject based on the ideXlab platform.
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complications and recovery from laparoscopy assisted vaginal Hysterectomy compared with abdominal and vaginal Hysterectomy
Obstetrics & Gynecology, 1997Co-Authors: Susan Meikle, Elizabeth Weston Nugent, Miriam OrleansAbstract:Objective To complete a systematic review of the published literature comparing complications, postoperative recovery time, and costs following laparoscopy-assisted vaginal Hysterectomy, total abdominal Hysterectomy (TAH), and vaginal Hysterectomy. Data Sources We searched MEDLINE and several bibliographies, identifying all reports using the term “laparoscopy-assisted Hysterectomy” published from 1989 to September 1995. Methods of Study Selection We excluded case reports, letters, and reports of laparoscopy-assisted vaginal Hysterectomy procedures used for radical cancer surgery, sex-change operations, total laparoscopic Hysterectomy, or supracervical Hysterectomy. Tabulation, Integration, and Results Cases identified included 3112 laparoscopy-assisted vaginal hysterectomies, 1618 TAHs, and 690 vaginal hysterectomies. Laparoscopyassisted vaginal Hysterectomy cases compared with TAH cases demonstrated significantly greater incidence of bladder injury (1.8% for laparoscopy-assisted vaginal Hysterectomy versus 0.4% for TAH; P = .01), significantly longer operating room time (115 minutes, standard deviation [SD] 37 minutes, for laparoscopy-assisted vaginal Hysterectomy versus 87 minutes, SD 18 minutes, for TAH; P P Conclusion Although laparoscopy-assisted vaginal Hysterectomy involves a shorter hospital stay, speedier postoperative recovery, and less analgesia use, there is also a higher rate of bladder injury and lengthier surgery. These outcomes must be weighed when choosing an intervention.
Giovan Fiore Catalano - One of the best experts on this subject based on the ideXlab platform.
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laparoscopically assisted vaginal Hysterectomy versus total abdominal Hysterectomy a prospective randomized multicenter study
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Riccardo Marana, M Busacca, E Zupi, Nicola Garcea, Pierluigi Paparella, Giovan Fiore CatalanoAbstract:Objective: The objective of this study was to evaluate short-term results of laparoscopically assisted vaginal Hysterectomy with those of total abdominal Hysterectomy in a prospective, randomized, multicenter study. Study Design: One hundred sixteen patients referred for abdominal Hysterectomy were randomized to either laparoscopically assisted vaginal Hysterectomy (58 patients) or abdominal Hysterectomy (58 patients). Inclusion criteria were one or more of the following, where a vaginal Hysterectomy would be traditionally contraindicated: uterine size larger than 280 g, previous pelvic surgery, history of pelvic inflammatory disease, moderate or severe endometriosis, concomitant adnexal masses or indication for adnexectomy, and nulliparity with lack of uterine descent and limited vaginal access. An upper limit of uterine size was set at 16 weeks’ gestation (ie, 700 g). Results: There were no differences in terms of patient’s age, parity, preoperative hemoglobin levels, mean uterine weight, and total operating time between the 2 groups. Estimated blood losses and postoperative day 1 hemoglobin drop were significantly lower for laparoscopically assisted vaginal Hysterectomy than for abdominal Hysterectomy (P < .05). There were 1 major and 2 minor complications in the laparoscopically assisted vaginal Hysterectomy group compared with 2 major and 5 minor complications in the abdominal Hysterectomy group (P not significant). Postoperative pain was lower for laparoscopically assisted vaginal Hysterectomy than for abdominal Hysterectomy on postoperative days 1, 2, and 3 (P < .05). Postoperative hospital stay was significantly shorter for laparoscopically assisted vaginal Hysterectomy than for abdominal Hysterectomy (P < .001). Conclusions: The present study demonstrates that, given adequate training in laparoscopic surgery, laparoscopically assisted vaginal Hysterectomy may replace abdominal Hysterectomy in most patients who require a Hysterectomy and have contraindications to vaginal Hysterectomy, with all the benefits associated with the vaginal route. (Am J Obstet Gynecol 1999;180:270-5.)
