Laparoscopic Hysterectomy

The first laparoscopic hysterectomy is described. Surgical techniques included aquadissection to develop appropriate tissue planes and bipolar electrosurgery to achieve hemostasis. The 38-year-old woman who elected to undergo this procedure had persistent pelvic pain secondary to pelvic adhesions from previous endometriosis surgery and hypermenorrhea due to uterine myomas. She was discharged on the fourth postoperative day and returned to full activity within 3 weeks. This case illustrates that hysterectomy can be accomplished using laparoscopy as the mode of access. In the future, titanium laparoscopic staples may replace bipolar electrosurgery for hemostasis. In selected patients, the laparoscopic approach to hysterectomy may avoid the increased morbidity associated with abdominal surgery while retaining the surgical advantages of the abdominal approach, i.e., thorough visualization and easy access to the vascular pedicles. (J GYNECOL SURG 5:213, 1989)