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LASH

German: LASH

1 Definition

LASH is the abbreviation used to describe a laparoscopic supracervical hysterectomy.

2 Procedure

A guiding instrument (manipulator) is placed in the uterus through the vagina. This enables the intraoperative movement of the uterus. Then the endoscope camera and instruments are inserted via small incisions (about 5-10mm length) into the CO2 filled abdomen. This enables the unproblematic separation of the ovaries and the fallopian tubes. Also Adhesions to the uterus or its adnexa can be removed.

The corpus uteri is separated from the cervix. This is often done electrically using a Lap Loop electrode which simultaneously coagulates and with that closes the stump of the cervix. Of course the manipulator has to be removed prior to doing this.

The corpus as a whole cannot be removed through one of the small incisions. This problem can be solved by using an electrical morcellator.

3 Indications

4 Contraindications

5 Advantages

The main arguments in support of the laparascopic supracervical hysterectomy (LASH) are:

  • minimally invasive access
  • reduction of morbidity caused from the operation
  • avoidance of feared aftereffects (such as shortening of the vagina, decline in sexuality, urinary incontinence) by maintain the integrity and stability of the pelvic floor.
  • low rate of intraoperative complications (since no preparation of the bladder is needed – decreased risk of lesions to the ureter)
  • short in-patient stay
  • quicker recovery time

6 Disadvantages

7 Links

AWMF Leitlinie zur LASH

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