Zusammenfassung
Die laparoskopische Hysterektomie ist ein etabliertes Verfahren. Schonender für die Patientinnen ist jedoch die vaginale Hysterektomie. In Fällen, in denen eine vaginale Hysterektomie erschwert ist, kann die Endoskopie die vaginale Entfernung des Uterus ermöglichen. Somit kann durch die Endoskopie eine abdominale Hysterektomie vermieden werden. Es hat sich gezeigt, dass die Morbidität nach laparoskopischer und vaginaler Operation gleichwertig ist. Beschrieben werden die verschiedenen Formen der laparoskopischen Hysterektomie.
Abstract
Laparoscopic hysterectomy is a globally accepted operation procedure but the best option for the patient is still the vaginal approach. In cases in which vaginal hysterectomy is difficult laparoscopy can be used to facilitate a vaginal removal route of the uterus hereby avoiding an abdominal hysterectomy. It has been shown that the laparoscopic and the vaginal approaches are equivalent with respect to morbidity. The different modalities of the laparoscopic hysterectomy are described in this article.
Literatur
Tozzi R, Malur S, Koehler C, Schneider A (2005) Analysis of morbidity in patients with endometrial cancer: is there a commitment to offer laparoscopy? Gynecol Oncol 97: 4–9
Stanton EM (1950) Supracervical hysterectomy for fibroids: a study of late end results. N Y State J Med 50: 2826–2828
Lyons TL (1997) Laparoscopic supracervical hysterectomy. Baillieres Clin Obstet Gynaecol 11: 167–179
Learman LA, Summitt RL Jr, Varner RE et al. (2003) A randomized comparison of total or supracervical hysterectomy: surgical complications and clinical outcomes. Obstet Gynecol 102: 453–462
Thakar R, Ayers S, Clarkson P et al. (2002) Outcomes after total versus subtotal abdominal hysterectomy. N Engl J Med 347: 1318–1325
Kuppermann M, Summitt RL Jr, Varner RE et al. (2005) Sexual functioning after total compared with supracervical hysterectomy: a randomized trial. Obstet Gynecol 105: 1309–1318
Lethaby A, Ivanova V, Johnson NP (2006) Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev 2: CD004993
Manyonda I, Thakar RB, Ayers S (2004) Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results. BJOG 111: 760–761
Thakar R, Ayers S, Georgakapolou A et al. (2004) Hysterectomy improves quality of life and decreases psychiatric symptoms: a prospective and randomised comparison of total versus subtotal hysterectomy. BJOG 111: 1115–1120
Zobbe V, Gimbel H, Andersen BM et al. (2004) Sexuality after total vs. subtotal hysterectomy. Acta Obstet Gynecol Scand 83: 191–196
Collinet P, Belot F, Debodinance P et al. (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17: 315–320
Winer WK, Lyons TL (1995) Suggested set-up and layout of instruments and equipment for advanced operative laparoscopy. J Am Assoc Gynecol Laparosc 2: 231–234
Schindlbeck C, Klauser K, Dian D, Janni W, Friese K (2008) Comparison of total laparoscopic, vaginal and abdominal hysterectomy. Arch Gynecol Obstet 277(4): 331–337
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dian, D., Rack, B., Schindlbeck, C. et al. Endoskopische Hysterektomie. Gynäkologe 41, 343–348 (2008). https://doi.org/10.1007/s00129-008-2134-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00129-008-2134-8