RESUMEN
STUDY OBJECTIVE: To introduce a surgical technique to minimize the chance of ureteral injury during laparoscopic-assisted vaginal hysterectomy (LAVH). DESIGN: Retrospective case review (Canadian Task Force classification II-3). SETTING: Show Chwan Memorial Hospital, Changhua, Taiwan. PATIENTS: Two thousand and six women who underwent LAVH between January 1992 and June 2001. INTERVENTION: A simple step of creating a "window" over the anterior and posterior broad ligaments to push inferolaterally the areolar tissue (in which the ureter is embedded) on the posterior broad ligament. MEASUREMENTS AND MAIN RESULTS: No ureteral injury occurred in patients whose cases were reviewed. There were, however, five bladder injuries (0.25%) and three nerve pareses (0.15%). Other minor complications, including fever, abscess or hematoma of the vaginal cuff, subcutaneous emphysema, and delayed vaginal cuff bleeding, occurred in less than 5% of patients. CONCLUSION: The technique proposed is simple and very effective in preventing ureteral injury during LAVH.
