LAPAROSCOPIC-ASSISTED VAGINAL HYSTERECTOMY, BILATERAL SALPINGO-OOPHORECTOMY, AND PELVIC LYMPH-NODE SAMPLING FOR ENDOMETRIAL CANCER

The use of laparoscopic-assisted vaginal hysterectomy has gained in popularity among gynecologic surgeons and is thought at present to be useful in converting a hysterectomy from an abdominal to a vaginal approach. The staging of endometrial cancer requires peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node sampling. This surgical staging requires a laparotomy incision, with a resulting minimum hospital stay of 3-5 days. In an effort to decrease the morbidity associated with this procedure, we report the use of laparoscopic surgery to assist with collection of peritoneal cytology, vaginal hysterectomy, ovarian removal, and pelvic node sampling. The potential usefulness and limitations of this technique are discussed. The role of laparoscopic-assisted hysterectomy for benign gynecologic disease and for endometrial cancer is in the formative stage.