assisted laparoscopic hysterectomy and 20 (15.5%) underwent total abdominal hysterectomy. Mean age of the younger laparoscopic group (Group 1) was 56.1 years old (range 33-64) and 72.8 years old (range 65- 86) for the elderly laparoscopic group (Group 2). Groups 1 and 2 were comparable with respect to body mass index and the number of prior surgeries. Group 2 had a greater percentage of patients with 1 or more major comorbidities (31.1% vs. 72.9%, p \0.01). There was no significant difference between group 1 and 2 with respect to: estimated blood loss, uterine weight, lymph node count, surgical time or surgical complications. Blood transfusion and conversion to laparotomy were rare in both groups. Mean postoperative stay for groups 1 and 2 was 2.4 days. Conclusion: Minimally invasive surgical staging for endometrial cancer is both feasible and safe in the elderly population and offers similar outcomes as seen in younger patients. 256 Open Communications 16dHysterectomy (2:39 PM d 2:44 PM) A Cost Effective Method of Total Laparoscopic Hysterectomy for Developing Nations Kashyap MA, Agarwal MS. Dr Kashyap Nursing Home and Centre for Gynecological Endoscopy, Pune, Maharashtra, India; Bliss Fertility Centre, Pune, Maharashtra, India Study Objective: To study the efficacy and safety of total laparoscopic hysterectomy using only a bipolar forceps, scissors and a single chip camera. Design: Retrospective analysis of 50 consecutive cases of total laparoscopic hysterectomy with a follow up at one week and three months. Setting: A private maternity and endoscopy unit in a developing country. Patients: Fifty women between the ages of 35 to 60 years underwent a total laparoscopic hysterectomy for various indications. Intervention: Total laparoscopic hysterectomy. Measurements and Main Results: A total laparoscopic hysterectomy was performed in all 50 women using only a bipolar forceps as the energy source in combination with laparoscopic scissors and a single chip camera. In 38 patients (76%), the procedure was completed under spinal anesthesia alone. Emphasis was on identification of tissue planes and visualisation of at least 2 cm of uterine artery before coagulation. The average blood loss was 15ml. The average time taken for surgery was one hour and forty minutes. 14 patients (7%) had a previous Caesarean section and required careful bladder dissection. In 4 patients (2%) there was pelvic endometriosis. Both these categories entailed lengthier surgery. There was no conversion to LAVH or open hysterectomy. All the patients were discharged on the 3rd postoperative day with minimal morbidity. Of the 42 patients who came for follow up at one week and three months, all were doing well. There were no delayed complications. Conclusion: Total laparoscopic hysterectomy using only a bipolar forceps, scissors and a single chip camera can be performed safely and effectively in countries where cost is a consideration for the type of instrumentation used. Majority of the cases were completed under spinal anesthesia which is very cost effective. Bringing down the cost of surgery ensures that we can offer the benefits of the laparoscopic approach to a larger segment of women who require hysterectomy. 257 Open Communications 16dHysterectomy (2:45 PM d 2:50 PM) Minilaparotomy Rescue Technique with the Mobius Retractor for Completion of Failed Vaginal Hysterectomy Pelosi MA II, Pelosi MA III. Pelosi Medical Center, Bayonne, New Jersey Study Objective: To assess the benefits and limits of a minilaparotomy technique that allows the completion of a failed vaginal hysterectomy as an alternative to laparotomy or laparoscopic rescue attempts. Design: Retrospective chart review of 8 patients who underwent a failed vaginal hysterectomy. Setting: Private gynecologic practice. Patients: The records of 8 patients who underwent a failed vaginal hysterectomy for the treatment of benign conditions (Large fibroids in 6 patients and severe endometriosis in 2 patients) were evaluated. Intervention: In these 8 patients an expeditious conversion procedure using the authors’ minilaparotomy technique with the Mobius self-retaining soft abdominal retractor was performed in order to avoid a traditional laparotomy and laparoscopy. Measurements and Main Results: All surgeries were completed without intra or postoperative complications.Operating time ranged from 38-65 minutes (mean 55 minutes).The mean blood loss was 135 ml.The range in uterine weight was 150-1,026 grams (average,600 grams).The average hospital stay was 24 hours, and return to normal activities and work,11 days. Conclusion: For the completion of an inefficient or failed vaginal hysterectomy, we present a redesigned minilaparotomy technique as an alternative to laparotomy that offers the same minimally invasive advantages of laparoscopy. In our experience this minilaparotomy rescue approach is faster than laparoscopy and easy to perform and teach., The procedure relies on the use of a novel inexpensive soft self-retaining abdominal retractor, traditional open techniques and uses the same surgical instruments of the vaginal hysterectomy. 258 Open Communications 16dHysterectomy (2:51 PM d 2:56 PM) Sexual Satisfaction Following Different Modes of Hysterectomy Lyapis A, 1 Dodge LE, 1 Tang K, 2 Hacker MR, 1 Hur H-C. 1 1 Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Brookline, Massachusetts; 2 Obstetrics and Gynecology, Legacy Good Samaritan Hospital, Portland, Oregon Study Objective: To analyze pre-operative sexual satisfaction among patients undergoing hysterectomy and to investigate the influence of laparoscopic-mode versus abdominal-mode of hysterectomy on post- operative sexual satisfaction. Design: Interim analysis of a prospective, multi-center study of women undergoing hysterectomy. Questionnaires were completed at baseline and post-operatively at 4, 6, and 12 months. A five-point Likert scale (1=very unsatisfied, 5=very satisfied) was used to assess sexual satisfaction. Data are reported as medians (interquartile range) and proportions. Setting: Two urban teaching hospitals in the Northwest and Northeast. Patients: Fifty-seven women were enrolled; 39 completed at least one post- operative questionnaire. Intervention: All laparoscopic and abdominal hysterectomies. Measurements and Main Results: Fifty-seven women with median age of 47.5 (43.3-50.8) underwent hysterectomy. Primary indication for surgery was fibroids (47%, n=27), followed by menorrhagia (19%, n=11), pelvic pain (10%, n=6), oncologic condition (7%, n=4), and ‘‘other’’ (17%, n=10). Eighty-six percent of women were pre- menopausal and 14% were post-menopausal. Thirty-six (63.2%) patients underwent laparoscopic hysterectomies and 21 (36.8%) had abdominal hysterectomies. Concurrent bilateral salpingo-oophorectomies were performed among 14 (25%) women and unilateral salpingo- oophorectomies in 8 (14%). Baseline sexual satisfaction was 4.0 (2.0- 5.0) for laparoscopic and 4.0 (2.0-5.0) for abdominal hysterectomy. Among women who underwent laparoscopic surgery, median baseline sexual satisfaction was 4.0 (1.0-5.0) for supracervical and 4.5 (1.0-5.0) for total hysterectomy. At six months, the median change in sexual satisfaction following laparoscopic and abdominal hysterectomy was 0.0 (-1.0-1.0) and 1.0 (0.0-2.0), which was not a significant change from baseline (P=0.68 and 0.10). After laparoscopic hysterectomy, the change at 6 months was 0.5 (-1.0-1.0) for supracervical hysterectomy and 0.0 (0.0-1.0) for total, which was not a significant change from baseline (P=1.00 and 0.76). S78 Abstracts / Journal of Minimally Invasive Gynecology 17 (2010) S69–S89