الفهرس 
THE HISTORY OF VAGINAL HYSTERECTOMYOnly 14 pages are availabe for public view
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Abstract
Background:
Hysterectomy is one of the most common surgical procedures in gynecological practice, that can be performed via abdominal, vaginal, laparoscopic, or combined approaches. Vaginal hysterectomy (VH) is the method of choice for removal of the uterus in patients with benign gynecological diseases.
The aim of the study was to compare the feasibility, safety and efficacy of using Deschamps needle technique versus conventional technique in cases with Non-descent vaginal hysterectomy (NDVH).
Methods: After ethical approval, a total number of 50 patients were recruited and eligible to participate in the study conducted at gynecology department ain shams university hospital during the period from December 2021 to December 2023. They all had vaginal hysterectomies for benign lesions , being divided randomly into 2 groups. group (A): 25 patients underwent VH using deschamps ligature needle technique, while group (B): 25 patients underwent VH using conventional technique.
Results: As regard demographic data (in terms of age, BMI, parity, menstrual status, previous abdominal surgery and co morbidities) there was no statistically significant difference between groups (p-value > 0.05). Also, Uterine volumes between two groups there was no statistically significant difference (P value 0.207). Both total operative time(93.20±7.03 - 102.28±9.8) and pedicle securing time(27.80±5.87- 34.60±7.02) were significantly longer in the conventional technique group compared to the deschamps group (P value is <0.001 – P value is 0.002 respectively). The mean intraoperative blood loss in group A was 351 ml and 391ml in group B which was non statistically significant (P value 0.4292). There was no statistically significant difference between two groups as regard pre, postoperative Hb & HCT values also neither Intra and postoperative blood transfusion nor hospital stay or mortality. Post operative pain was statistically significant between two groups where group A showed less pain and need to postoperative analgesia (P value is <0.0001). As regard complication, only one case in group B was complicated with bladder injury(4%) repaired vaginally, one case in group A had postoperative urine retention resolved spontaneously after one week, two cases in group A had postoperative pyrexia (8%) in contrast to three cases in group B (12%), lastly after one week one case(4%) developed UTI symptoms in group A in contrast to two cases in group B(8%).
Conclusion:.VH using deschamps ligature needle technique represents a safer and less minimally-invasive technique in women with benign non-descent uteri and significantly less total operative and pedicle securing time than conventional technique without increasing rate of complications provided that special precautions are taken to avoid it .