الفهرس 
Anatomy of the UterusOnly 14 pages are availabe for public view
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Abstract
¬Three main types of hysterectomy are now used abdominal, vaginal, and laparoscopic. Traditionally, abdominal hysterectomy has been used for gynecological malignancy when other pelvic disease is present, such as endometriosis or adhesions or if the uterus is enlarged. It remains the “fallback option” if the uterus cannot be removed by another approach. Hysterectomy is one of the most frequently performed gynaecologic surgical procedures. The laparoscopic method, charachtariezed by earlier return to normal activities, lower intra operative blood loss, fewer wound infections, and shorter hospital stay.
Abdominal Hysterectomy (AH) is the standard procedure for gynecological malignancy and several benign indications While the abdominal surgical approach is an accepted effective treatment, it is associated with substantial morbidity, mostly wound problems on the short term) and incisional hernias on the long term.
Vaginal hysterectomy (VH) is the surgical route of choice for benign hysterectomy. This study was conducted at Ain Shams University Maternity Hospital, from period of May 2010 to February 2012 after approval from ethical Committee .
Ninety patients who were admitted from gynecologic outpatient clinic to undergo hysterectomy were enrolled. .The study population was randomized into 3 groups using EBVS. The aim of the current study was to to compare the safety and efficacy of total laparoscopic hyesterectomy versus abdominal versus vaginal hyesterectomy using the electrosurgical bipolar vessel sealing using ligasure.
90 patients were randomized to either VH, or TLH or TAH for benign pathology using electrosurgical bipolar vessel sealing as the haemostasis technique. Procedure time was defined as time from the start of operation till the with satisfactory haemostasis.The Blood loss was estimated intraoperatively by the anaesthesia service and postoperatively by measuring haemoglobin & haematocrit values. Postoperative pain score was estimated by visual analoge scale.as regard the results of our study ther was no statistical difference between VH, TLH and TAH as regard body mass indix, parity, age, uterine size and uterine weight. Post operative pain score and need for analgesia was less in TLH than the other two groups while Postoperative pain score and need for analgesia was less in VH than AH groups.the operative time was longer in TLH than AH and VH groups but VH took shorter operative time than LH and AH.the operative complication was more with VH and AH groups the blood loss more with VH than AH and LH groups.