Retrospective study on laparoscopic hysterectomy by vaginal vault closure method in a tertiary care centre

Pradeep Ganiga, Divyashree B.


Background: Hysterectomy is the frequently performed operation for benign conditions of uterus, but the route of hysterectomy is always a matter of discussion. Laparoscopic hysterectomy is an expensive and time-consuming procedure and could be associated with increased risk of thermal damage related injuries to the surrounding structures. Presently, laparoscopic hysterectomy is considered to be a day care surgery because of technological improvement in electro-surgical unit and expertise of doing surgery. The objective of this study was as a retrospective observational study conducted in teaching hospital to study the factors like age, parity, indication and procedure related complications in detail.

Methods: A total number of 40 patients who have undergone laparoscopic hysterectomy for various indications with vault closure by vaginal method with no. 1 PDS. A detailed analysis of cases was done according to age, parity, indication, intra-operative and post-operative outcomes.

Results: Fibroid uterus was the most common indication for laparoscopic hysterectomy. Overall postoperative complication rate was 22.5% with no major morbidity reported.

Conclusions: Laparoscopic hysterectomy has to be done with proper selection of patient and good peri-operative care. Vault closure by vaginal method has significantly reduced operating time, without increasing the morbidity.


Electro-surgical unit, Laparoscopic hysterectomy, Parity index, Vaginal vault

Full Text:



Kavallaris A, Chalvatzas N, Kelling K, Bohlmann MK, Diedrich K, Hornemann A. Total laparoscopic hysterectomy without uterine manipulator: description of a new technique and its outcome. Arch Gynecol Obstet. 2011 May 1;283(5):1053-7.

Reich H, DeCAPRIO JO, McGLYNN FR. Laparoscopic hysterectomy. J Gynecol Surgery. 1989;5(2):213-6.

Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane database syst rev. 2009 Jul 8;3(8).

Wattiez A, Soriano D, Cohen SB, Nervo P, Canis M, Botchorishvili R, et al. The learning curve of total laparoscopic hysterectomy: comparative analysis of 1647 cases. The J Am Assoc Gynecol Laparoscopists. 2002 Aug 1;9(3):339-45.

Mettler L, Ahmed‐Ebbiary N, Schollmeyer T. Laparoscopic hysterectomy: challenges and limitations. Minimally Invasive Therapy Allied Technologies. 2005 Jun 1;14(3):145-59.

Saleh MM, Seoud AA, Zaklama MS. Challenges of laparoscopic hysterectomy: a 10-year experience in UK hospitals. Gynecol Surgery. 2008 May 1;5(2):115-20.

Perino A, Cucinella G, Venezia R, Castelli A, Cittadini E. Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study. Human Reprod. 1999 Dec 1;14(12):2996-9.

Pattanaik T, Mishra SP, Das S. Total Laparoscopic Hysterectomy-A Retrospective Observational Study in a Teaching Hospital.

Eken MK, İlhan G, Temizkan O, Çelik EE, Herkiloğlu D, Karateke A. The impact of abdominal and laparoscopic hysterectomies on women’s sexuality and psychological condition. Turkish J Obstet Gynecol. 2016 Dec;13(4):196.

Donnez O, Donnez J. A series of 400 laparoscopic hysterectomies for benign disease: a single centre, single surgeon prospective study of complications confirming previous retrospective study. BJOG: An I J Obstet Gynaecol. 2010 May 1;117(6):752-5.

Hill DJ, Maher PJ, Wood CE, Lolatgis N, Lawrence A, Dowling B, et al. Complications of laparoscopic hysterectomy. The J Am Assoc Gynecol Laparoscopists. 1994 Feb 1;1(2):159-62.

Wang H, Li P, Li X, Gao L, Lu C, Zhao J, et al. Total laparoscopic hysterectomy in patients with large uteri: comparison of uterine removal by transvaginal and uterine morcellation approaches. BioMed Research International. 2016;2016.

David-Montefiore E, Rouzier R, Chapron C, Darai E, Collegiale d’Obstétrique et Gynécologie de Paris-Ile de France. Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French university hospitals. Human Reprod. 2007 Jan 1;22(1):260-5.

Arsen JM. Comparative Analysis of Laparoscopic and Vaginal Hysterectomy-Postoperative Pain. J Universal Surgery. 2017 Mar 30;5(2).