Characteristics and management of large bowel injury in laparoscopic-assisted vaginal hysterectomy

Study Objective. To review laparoscopic-assisted vaginal hysterectomies (LAVH) for large bowel injuries. Design. Retrospective review (Canadian Task Force classification II-2). Setting. University-affiliated hospital. Patients. Two thousand eighty-four women. Intervention. LAVH. Measurements and Main Results. Indications for hysterectomy were myomata uteri, adenomyosis, intractable menorrhagia, endometriosis, severe pelvic adhesions, cervical intraepithelial neoplasia, endometrial polyps, and hyperplasia. Large bowel injuries occurred in six women (2.9/1000), only one of which was recognized post-operatively. Colostomy was performed in four patients, simple repair in one, and laparoscopic repair in one. All these patients were discharged without sequelae. Conclusion. In our experience, bowel injury during LAVH was not a common event.