By Royal Ibeh
While there is no perfect technique to perform hysterectomy, the minimally invasive vaginal hysterectomy is the safest approach, revealed experts in gynaecology.
Experts, at a webinar organised by the Society of Gynaecology and Obstetrics of Nigeria (SOGON), Nordica Fertility Centre and Erbe Elektromedizin GmbH, said the three approaches of performing hysterectomy are vaginal, laparoscopy and abdominal.
Themed: “Various Approaches in Hysterectomy”, the gynaecologists said there is no perfect technique to perform hysterectomy, while adding that the safest approach in hysterectomy is the vaginal, followed by the laparoscopy and then the abdominal.
Head of minimally invasive and robotic gynaecologic surgery unit, University Hospital of Modena, Italy, Dr Carlo Alboni said the benefits a patient derived from the minimally invasive vaginal hysterectomy cannot be overemphasized, adding that 10 years ago, scientists discovered that the ideal approach/technique for hysterectomy has to be minimally invasive, cosmetic, effective, cheap and if possible, time saving.
“All these features are the features of the minimally invasive vaginal hysterectomy. It is minimally invasive, meaning there is a very small impact on the physical and psychological aspects of the patient; the uterus is taken away from the natural orifice; it is cosmetic because we are talking about women, so it is better not to destroy the abdomen; it is effective; cheap and time saving,” he added.
To perform this type of hysterectomy, Alboni said, “The first fundamental thing to do is the vessel sealing system (sutureless). You need perfect sealer to do this kind of surgery because your surgery has to be sutureless. Next, you have to transform the shape of your uterus from pear-shaped to apple shaped, to enable rotation inside the vaginal/pelvic. Finally, you have to do the sealing of the content of the broad ligament. With the sealing method, you can achieve a complete closure that can resist a higher pressure than the normal bipolar,” he added.
While laparoscopic hysterectomy is an approach with few contraindications, associate professor of Gynaecologist, Helwan University of Cairo, Egypt, Dr Hossam Abdel-Mageed said it cannot compete with vaginal hysterectomy because of the huge benefits.
The managing director, French Board, Aboujaoude Hospital, Beirut, Lebanon, Dr Imad Aboujaoude, said, 85 per cent of hysterectomy performed at Aboujaoude Hospital was through the vaginal, adding that he personally have a preference for vaginal hysterectomy because it is safe with low risk of complications.
In their closing remarks, stakeholders like the national president, SOGON, Prof Oluwarotimi Akinola and a member of SOGON, Abayomi Ajayi, however urged gynaecologists to use the best approach in hysterectomy with the right instruments that is less traumatic and would benefit the patient maximally when performing hysterectomy.