Minilaparotomy hysterectomy assisted by self-retaining elastic abdominal retractor.

STUDY

OBJECTIVE

To verify the efficacy and safety of minilaparotomy hysterectomy using a self-retaining elastic abdominal retractor.

DESIGN

Retrospective study (Canadian Task Force classification II-3).

SETTING

Private hospital, department of obstetrics and gynecology.

PATIENTS: One-hundred-fifty women, age 37 to 76 years, with benign uterine pathology or preinvasive neoplasia.

INTERVENTION: Minilaparotomy hysterectomy assisted by a self-retaining elastic abdominal retractor.

MEASUREMENTS AND MAIN

RESULTS

The mean surgical time was 70 +/- 23.5 minutes (95% CI 63.1-70.7). There were no intraoperative complications. There was no need to extend the initial incision. Eight patients developed complications during the immediate postoperative period (fever in 2, hematoma of the surgical wound in 2, sub-aponeurotic seroma in 2, pubic edema in 1, and pulmonary embolism in 1). During the late postoperative period, a vaginal cuff dehiscence was reported. Mean postoperative hospital stay was 2.5 +/- 0.2 days (95% CI 2.4-2.6).

CONCLUSION

Minilaparotomy hysterectomy assisted by a self-retaining abdominal elastic retractor is a safe and effective minimally invasive procedure. Also, it appears to be a good alternative to laparoscopic hysterectomy for institutions that do not have the required expensive equipment or for gynecologists who do not have laparoscopic experience.