Trends and patterns in total laparoscopic hysterectomy in tertiary care hospital

Sonali Ingole; Sameer Darawade

doi:10.18203/2320-1770.ijrcog20182008

Authors

Sonali Ingole Department of Obstetrics and Gynecology, SKN Medical College, Pune, Maharashtra, India
Sameer Darawade Department of Obstetrics and Gynecology, SKN Medical College, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20182008

Keywords:

Abdominal hysterectomy, TLH, Vaginal hysterectomy

Abstract

Background: Due to technical advances in the field of laparoscopy, there has been an increase in total laparoscopic hysterectomies all over the world in last decade. This study was conducted to analyse the technique and surgical outcome of total laparoscopic hysterectomy in tertiary care hospital

Methods: This is a retrospective cohort (observational) study, which included all patients who underwent Total Laparoscopic Hysterectomy (TLH) for benign conditions from January 2012 to December 2017 at the tertiary Care Hospital. The data so obtained was analysed for various parameters like indication for surgery, mean operating time, length of hospital stay, complications and conversion to abdominal route.

Results: Total number of 2307 hysterectomies were performed over a period of 5 years. Of these, TLH were 270 (11.70%). Amongst those undergoing TLH, the mean age was 45±7.84 years. The most common indication for the surgery was fibroid uterus (38.14%), followed by dysfunctional uterine bleeding (28.88%), and adenomyosis (15.1%). The mean estimated blood loss was 106±4.34 ml. Hemorrhage (n = 2) and bladder injury (n = 4) were most common surgical complications.

Conclusions: TLH is safe and effective procedure for most of the benign pelvic conditions. With adequate training TLH can be used more widely in tertiary care hospital and teaching institute.

Metrics

Metrics Loading ...

References

Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R. Methods of hysterectomy: systematic review and meta-analysis of randomized controlled trials. BMJ. 2005;330(7506):1478.

Long CY, Fang JH, Chen WC, Su JH, Hsu SC. Comparison of total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy. Gynecol Obstet Invest. 2002;53:214-9.

Harry R, Lisa R. Laparoscopic hysterectomy in current gynecological practice. Gynocol Perinatal Prac. 2003;3:32-40.

Sutton C. Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol. 1997;11(1):1-22.

Wood C, Maher PJ. Laparoscopic hysterectomy. Baillieres Clin Obstet Gynaecol. 1997;11(1):111-36.

Thiel J, Gamelin A. Outpatient total laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc. 2003;10(4):481-3.

Chapron C, Dubuisson JB, Ansquer Y. Total laparoscopic hysterectomy: indications, results, and complications. Ann N Y Acad Sci. 1997;828:341-51.

Hawe JA, Garry R. Laparoscopic hysterectomy. Semin Laparosc Surg. 1999;6(2):80-9.

Ottosen C, Lingman G, Ottosen L. Three methods for hysterectomy: a randomized, prospective study of short term outcome. BJOG. 2000;107:1380-5.

Cheung VYT, Rosenthal DM. Laparoscopic versus abdominal supra cervical hysterectomy. J Am Assoc Gynecol Laparosc. 2002;9:S68.

Garry R, Fountain J, Mason S, Napp V, Brown J, Hawe J, et al. The evaluate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004;328:129-36.

Cheung VYT, Rosenthal DM. TLH versus LAVH. J Am Assoc Gynecol Laparosc. 2002;9:S8.

Liu C, Reich H. Complications of total laparoscopic hysterectomy in 518 cases. Gynaecol Endosc. 1994;3:203-8.

Garry R. The future of hysterectomy. BJOG. 2005;112:133-9.