Small intestine injury in laparoscopic-assisted vaginal hysterectomy.

The Journal of the American Association of Gynecologic Laparoscopists

PubMedID: 14567810

Shen CC, Wu MP, Lu CH, Hung YC, Lin H, Huang EY, Huang FJ, Hsu TY, Chang SY. Small intestine injury in laparoscopic-assisted vaginal hysterectomy. J Am Assoc Gynecol Laparosc. 2003;10(3):350-5.
STUDY OBJECTIVE
To review laparoscopic-assisted vaginal hysterectomy (LAVH) cases for instances of small intestine injury.

DESIGN
Retrospective review (Canadian Task Force Classification II-2).

SETTING
Tertiary care university hospital.

PATIENTS
Two thousand six hundred eighty-two women.

INTERVENTION
LAVH.

MEASUREMENTS AND MAIN RESULTS
Indications for hysterectomy were myomata uteri, adenomyosis, intractable menorrhagia, endometriosis, severe pelvic adhesions, cervical intraepithelial neoplasia, endometrial polyps, and hyperplasia. Small bowel injuries occurred in five women (1.9/1000), one (20%) of which was recognized postoperatively. Thermal injuries occurred in two patients, trocar injuries in two, and a dissection wound in one. Two-layer closure was performed for three patients, and partial resection with reanastomosis for two. All patients were discharged without sequelae.

CONCLUSION
Small bowel injury during LAVH is not common. It may have unusual characteristics and devastating consequences if not recognized and treated promptly.