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The feasibility of vaginal hysterectomy.

OBJECTIVE: To assess the feasibility of vaginal hysterectomy for benign uterine disease and to assess how frequently laparoscopic assistance is necessary.

METHODS: A prospective series of 806 hysterectomies for benign disease of the uterus without prolapse which were performed in our institution from 1 March 1991 to 28 February 1994 is discussed. The report is an evaluation of a planned approach for hysterectomy. Vaginal hysterectomy was performed whenever possible-laparoscopic hysterectomy was indicated for adnexal pathology, known or anticipated significant pelvic adhesions and for a narrow vaginal access with a moderately enlarged uterus-abdominal hysterectomy was chosen when both laparoscopic and vaginal surgery were judged to be impossible.

RESULTS: Vaginal hysterectomy was performed in 80.6% of patients. Laparoscopic assistance was needed in 9.4% of cases. The need for laparotomy was reduced to 10% with an acceptable pre- or postoperative complications rate.

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