Total laparoscopic hysterectomy and bilateral salpingo-oophrectomy for stage 1 endometrial carcinoma under regional anaesthesia

Abstract

Total Laparoscopic hysterectomy is most commonly performed under general anesthesia. In elderly patients with severe medical co-morbidities and endometrial malignancy, laparoscopic surgery under general anesthesia can be hazardous. In such patients, regional anesthesia is safe, and can be the only option. We present a case of 75-year old women with severe lung fibrosis, chronic obstructive airway disease and heart failure who presented with severe post-menopausal bleeding and was diagnosed with endometrial carcinoma. She was considered unfit for general anesthesia. After multidisciplinary team meeting, the patient underwent total laparoscopic hysterectomy, bilateral salpingo-oophrectomy and peritoneal washings under regional anaesthesia. The procedure was successful and the patient was discharged 24 h later. In this case report, we demonstrate the anesthetic and surgical techniques for total laparoscopic hysterectomy under regional anesthesia. In the presence of dedicated multidisciplinary team, laparoscopic hysterectomy for endometrial carcinoma under regional anesthesia is safe and feasible.

Keywords

• Laparoscopy
• Hysterectomy
• Uterine cancer
• Epidural
• Endometrial cancer