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Laparoscopy vs. laparotomy for gynecologic procedures. Impact on resident training.
J Reprod Med. 1996 Apr; 41(4):225-30.JR

Abstract

OBJECTIVE

To compare laparoscopic approaches to traditional ones for operative procedures.

STUDY DESIGN

Operating residents collected data on all abdominal, vaginal and laparoscopic vaginal hysterectomies, myomectomies, cystectomies/oophorectomies and ectopics between December 1, 1992, and July 31, 1993. Statistical analysis included Student's t test for interval data and chi (2)/Fisher's exact test for categorical data.

RESULTS

Leiomyomas were the major indications for all three types of hysterectomy. Patients selected for vaginal hysterectomy had significantly higher parity and older age than those scheduled for abdominal hysterectomy or laparoscopically assisted vaginal hysterectomy (LAVH). Abdominal hysterectomy uteri were larger than those using vaginal or LAVH procedures. LAVH procedures were significantly longer when failed laparoscopic procedures were excluded. Abdominal hysterectomy patients used twice as much morphine as vaginal and LAVH patients, and the length of stay was longer. LAVH was significantly more expensive than vaginal hysterectomy. There was no difference in operating time for nonhysterectomy cases, but the cost and length of stay were less for laparoscopy.

CONCLUSION

Laparoscopy can be advantageous for certain procedures but has little advantage for hysterectomy and may make fewer vaginal hysterectomies available for resident education since the patients selected for LAVH and total vaginal hysterectomy are more similar to each other than to patients selected for total abdominal hysterectomy.

Authors+Show Affiliations

Sultana CJ
Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Sogor L
No affiliation info available

MeSH

AdultBiopsyCost-Benefit AnalysisFemaleGynecologyHumansHysterectomyHysterectomy, VaginalInternship and ResidencyLaparoscopyLaparotomyLength of StayMyometriumOvarian CystsOvariectomyOvaryPregnancyPregnancy, Ectopic

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8728072

Citation

Sultana, C J., and L Sogor. "Laparoscopy Vs. Laparotomy for Gynecologic Procedures. Impact On Resident Training." The Journal of Reproductive Medicine, vol. 41, no. 4, 1996, pp. 225-30.
Sultana CJ, Sogor L. Laparoscopy vs. laparotomy for gynecologic procedures. Impact on resident training. J Reprod Med. 1996;41(4):225-30.
Sultana, C. J., & Sogor, L. (1996). Laparoscopy vs. laparotomy for gynecologic procedures. Impact on resident training. The Journal of Reproductive Medicine, 41(4), 225-30.
Sultana CJ, Sogor L. Laparoscopy Vs. Laparotomy for Gynecologic Procedures. Impact On Resident Training. J Reprod Med. 1996;41(4):225-30. PubMed PMID: 8728072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopy vs. laparotomy for gynecologic procedures. Impact on resident training. AU - Sultana,C J, AU - Sogor,L, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 225 EP - 30 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 41 IS - 4 N2 - OBJECTIVE: To compare laparoscopic approaches to traditional ones for operative procedures. STUDY DESIGN: Operating residents collected data on all abdominal, vaginal and laparoscopic vaginal hysterectomies, myomectomies, cystectomies/oophorectomies and ectopics between December 1, 1992, and July 31, 1993. Statistical analysis included Student's t test for interval data and chi (2)/Fisher's exact test for categorical data. RESULTS: Leiomyomas were the major indications for all three types of hysterectomy. Patients selected for vaginal hysterectomy had significantly higher parity and older age than those scheduled for abdominal hysterectomy or laparoscopically assisted vaginal hysterectomy (LAVH). Abdominal hysterectomy uteri were larger than those using vaginal or LAVH procedures. LAVH procedures were significantly longer when failed laparoscopic procedures were excluded. Abdominal hysterectomy patients used twice as much morphine as vaginal and LAVH patients, and the length of stay was longer. LAVH was significantly more expensive than vaginal hysterectomy. There was no difference in operating time for nonhysterectomy cases, but the cost and length of stay were less for laparoscopy. CONCLUSION: Laparoscopy can be advantageous for certain procedures but has little advantage for hysterectomy and may make fewer vaginal hysterectomies available for resident education since the patients selected for LAVH and total vaginal hysterectomy are more similar to each other than to patients selected for total abdominal hysterectomy. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/8728072/Laparoscopy_vs__laparotomy_for_gynecologic_procedures__Impact_on_resident_training_ DB - PRIME DP - Unbound Medicine ER -