DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170594

A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

Shibram Chattopadhyay, Kajal Kumar Patra, Madhusudan Halder, Apurba Mandal, Preetam Pal, Shritanu Bhattacharyya

Abstract


Background: Hysterectomy is the most common performed major gynaecological surgery and the decision depends on indications for operation, surgeon’s training and preference, uterine size, adnexal pathologies and patient choice. To avoid laparotomy either total laparoscopic hysterectomy (TLH) or non-descent vaginal hysterectomy (NDVH) is the recently practised option. Objectives of the present study are to compare duration of operation, blood loss, ambulation time, post-operative pain and complications between TLH and NDVH.

Methods: Patients undergoing above operation during January 2014 to December 2014 at N.R.S. Medical College, Kolkata, were included under the study. All patients were thoroughly examined and investigated and malignancies were excluded by Pap smear and or D&C. All patients were observed minutely during pre-operative, intra operative and post-operative period for any complications.

Results: NDVH requires less operative time than TLH but intra operative blood loss, post-operative pain and ambulation time are slightly more.

Conclusions: TLH requires infrastructural set up, greater surgical expertise, longer operative time and major intraopertive complications as compared to NDVH. In our low resource government hospital NDVH is better choice for removal of uterus in uncomplicated benign conditions.


Keywords


Hysterectomy, NDVH, Pap smear, TLH

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References


Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA. Centre for Disease control (CDC) MMWR. Hysterectomy surveillance-United States,1994-1999. Surveillance Summaries. 2002;51:1-8.

Singh AJ, Arora AK. Effect of uterine prolapse on the lines of rural North Indian women. Singapore. J Obstet Gynecol. 2003;34:52-8.

Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J. A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol. 2010;148(2):172-6.

US Census Bureau, International Data Base, 2004.

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BJ, Kluivers KB. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev.2015

Muller A, Thiel FC, Renner SP, Habenle, Beckmann MW. Hysterectomy-a comparison of approaches. Dtsch Arztebl Int. 2010;107(20):353-9.

Aniuliene R, Varzgaliene L, Varzgalis M. A comparative analysis of hysterectomies. Medicina (Kaunas). 2007;43(2):118-24.

Morton M, Cheung VY, Rosenthal DM. Total laparoscopic versus vaginal hysterectomy: a retrospective comparison. J Obstet Gynaecol Can. 2008;30:1039-44.

Roy KK, Goyal M, Singla S, Sharma JB, Malhotra N, Kumar S. A prospective randomised study of total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus. Arch Gynecol obset. 2011;284(4):907-12.

Walsh CA, Walsh SR, Gendy R, Karantanis E. Vaginal hysterectomy laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials. Am J Obstet Gynecol. 2011;204:388.