Histerectomía mínimamente invasiva a través de laparoscopia con bisturí ultrasónico

Abstract

Objective: To evaluate the security, effectiveness and reproducibility of the laparoscopic hysterectomy by ultrasonic scalpel. To discuss the comparatives advantages with the electro surgery technique. Method: A descriptive prospective study about 18 patients underwent laparoscopic hysterectomy with ultrasonic scalpel in Las Condes Clinic. The age fluctuated between 38 and 66 years old (median 47 years old). The median parity was 2 childbirths. The body mass index was 28. 5 total laparoscopic hysterectomies (TLH), 9 supracervical laparoscopic hysterectomies (SLH) and 4 total hysterectomies finished by vaginal route (TLHFV) were made. In 13 patients other surgery was associated. Results: The surgical time for SLH was between 23 and 45 minutes (mean 35 minutes), for LTH between 45 and 90 minutes (mean 65 minutes), for TLHFV between 60 and 90 minutes (mean 75 minutes). Complications were not registered during the intraoperative, immediate, early or late postoperative times. The visual analogue scale for pain at 12 hours was 2 to 5 for LTH, 0 to 2 for SLH, and 2 to 5 for TLHFV; at 24 hours was 2 to 4 for HTL, 0 to 2 for SLH and 2 to 5 for TLHFV. Conclusions: The laparoscopic hysterectomy with ultrasonic scalpel is a safe, effective and feasible surgery allows to cut and to coagulate with comparative advantages on electrosurgery. It allows reducing the damage of near tissues and organs. The ultrasonic scalpel has the potential to become one of the energies preferred for the laparoscopies surgeries.