Assessment of the learning curve: total laparoscopic hysterectomy versus total abdominal hysterectomy


  • Nutan Yadav Department of Obstetrics and Gynecology, MGM Institute of Health Science, Navi Mumbai, Maharashtra, India
  • Priyanka Tiwari Department of Obstetrics and Gynecology, MGM Institute of Health Science, Navi Mumbai, Maharashtra, India
  • Abhishek Mangeshikar Department of Obstetrics and Gynecology, MGM Institute of Health Science, Navi Mumbai, Maharashtra, India
  • Sushil Kumar Department of Obstetrics and Gynecology, MGM Institute of Health Science, Navi Mumbai, Maharashtra, India



Total abdominal hysterectomy, Total laparoscopic hysterectomy


Background: Abdominal hysterectomy is the most frequented way of hysterectomy in the world; today we have a lot of techniques for hysterectomy. Total Laparoscopic Hysterectomy (TLH) versus Total Abdominal Hysterectomy (TAH) needs experience an assessment of the learning curve. Objective of the study was to determine the feasibility and safety of TLH and TAH.

Methods: Total 100 women were taken for study. Operating time, estimated blood loss, operating complication and length of stay in hospital were noted for each patient. The success rates of TLH were more compared to TAH. The operating time estimated blood loss, conversion to laparotomy was directly proportional to size of uterus.

Results: There were no statistically significant differences between the two groups regarding age, body mass index (BMI), specimen weight, pre-operative hemoglobin (Hb) value and rates of the complications. The mean post-operative Hb value was significantly higher in group TLH than group TAH (11.3±0.7 gr/dl versus 10.6±1.6, p = 0.03). The mean time of operation was significantly longer in TLH than group TAH (105.4±22.9 minutes versus 74±18, p<0.001). The mean duration of hospital stay was statistically shorter in TLH compared to the TAH (2.47±0.5 days versus 4.86±1.1, p<0.001).

Conclusions: Advantage of TLH over TAH are less blood loss, fewer wound infection and fever, smaller incisions, with less pain, shorter hospitalization time, speedier recovery.


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