Small intestine injury in laparoscopic-assisted vaginal hysterectomy.

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.