DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20195361

Total laparoscopic hysterectomy: a retrospective study of 5 years

Suma S. Moni, Suchith Hoblidar, Rathnamala M. Desai, Sunil Kumar K. S.

Abstract


Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.

Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.

Results: A total of 118 women were included in the study. Mean age of the patients was

Most common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.

Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.


Keywords


Abnormal uterine bleeding, Hysterectomy, Learning curve, Operating time, Total laparoscopic hysterectomy

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References


Farquhar CM, Steiner CA. Hysterectomy rates in the United States 1990-1997. Obstet Gynecol. 2002;99:229-34.

Prusty RK, Choithani C, Gupta SD. Predictors of Hysterectomy among married women 15-49 years in India. Reprod Health. 2018;15:3.

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

Mathew P, Aggarwal N, Kumari K, Gupta A, Panda N, Bagga R. Quality of recovery and analgesia after total abdominal hysterectomy under general anesthesia: a randomized controlled trial of TAP block versus epidural analgesia versus parenteral medications. J Anaesthesiol Clin Pharmacol. 2019;35(2):170-5.

Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg. 1989;5:2:3-16.

Kim SM, Park EK, Jeung IC, Kim CJ, Lee YS. Abdominal, multi-port and single-port total laparoscopic hysterectomy: eleven-year trends comparison of surgical outcomes complications of 936 cases. Arch Gynecol Obstet. 2015;291:1313-9.

Donnez O, Jadoul P, Squifflet J, Donnez J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG. 2009;116:492-500.

Bonilla DJ, Mains L, Rice J, Crawford B. Total laparoscop- IC hysterectomy: our 5-year experience (1998-2002). The Ochsner J. 2010;10:8-12.

Bettaiah R, Reddy CA. Laparoscopic hysterectomies: our 10 years-experience in a single laparoscopic center. J Obstet Gynaecol India. 2016;66:274-81.

O'Hanlan KA, Dibble SL, Garnier AC, Reuland ML. Total laparoscopic hysterectomy: technique and complications of 830 cases. JSLS. 2007;11(1):45-53.

Hoffman CP, Kennedy J, Borschel L, Burchette R, Kidd A. Laparoscopic hysterectomy: the Kaiser Permanente San Diego experience. J Minim Invasive Gynecol. 2005;12(1):16-24.

Heinberg EM, Crawford BL, Weitzen SH, Bonilla DJ. Total laparoscopic hysterectomy in obese versus nonobese patients. Obstet Gynecol. 2004;103(4):674-80.

Chapron C, Dubuisson JB, Ansquer Y, Fernandez B. Total hysterectomy for benign pathologies. Laparoscopic surgery does not seem to increase the risk of complications. J Gynecol Obstet Biol Reprod (Paris). 1998;27(1):55-61.

Adelman MR, Bardsley TR, Sharp HT. Urinary tract injuries in laparoscopic hysterectomy: a systematic review. J Minim Invasive Gynecol. 2014;21(4):558-66.

Lee SH, Oh SR, Cho YJ, Han M, Park JW, Kim SJ, et al. Comparison of vaginal hysterectomy and laparoscopic hysterectomy: a systematic review and meta-analysis. BMC Women's Health. 2019;19(1):83.

Garry R. The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004;328:129.

Canis MJ, Wattiez A, Mage G, Bruhat MA. Results of eVALuate study of hysterectomy techniques: laparoscopic hysterectomy may yet have a bright future. BMJ. 2004;328:642-3.

Donnez J, Squifflet J, Jadoul P, Smets M. Results of eVALuate study of hysterectomy techniques: high rate of complications needs explanation. BMJ. 2004;328:643.

Garry R. Re‐evaluating the eVALuate study and the NICE guidelines: a personal review. An Int J Obstet Gynaecol. 2016;123(11):1796.

Sandberg EM, Twijnstra ARH, Driessen SRC, Jansen FW. Total laparoscopic hysterectomy versus vaginal hysterectomy: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2017;24(2):206-17.

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

McMaster-Fay RA, Jones RA. Laparoscopic hysterectomy and ureteric injury: a comparison of the initial 275 cases and the last 1,000 cases using staples. Gynecol Survey. 2006;3(2):118-21.

Donnez O, Jadoul P, Squifflet J, Donnez J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG. 2009;116(4):492-500.

Polat M, Kahramanoglu I, Senol T, Senturk B, Ozkaya E, Karateke A. J comparison of the effect of laparoscopic and abdominal hysterectomy on lower urinary tract function, vaginal length, and dyspareunia: a randomized clinical trial. J Laparoendosc Adv Surg Tech. 2016;26(2):116-21.

Kürek Eken M, İlhan G, Temizkan O, Çelik EE, Herkiloğlu D, Karateke A. The impact of abdominal and laparoscopic hysterectomies on women's sexuality and psychological condition. Turk J Obstet Gynecol. 2016;13(4):196-202.

Vaisbuch E, Goldchmit C, Ofer D, Agmon A, Hagay Z. Laparoscopic hysterectomy versus total abdominal hysterectomy: a comparative study. Eur J Obstet Gynecol Reprod Biol. 2006;126(2):234-8.

Sinha R, Swarnasree G, Rupa B, Madhumathi S. Laparoscopic hysterectomy for large uteri: Outcomes and techniques. J Minim Access Surg. 2019;15(1):8-13.

Keurentjes JHM, Briët JM, de Bock GH, Mourits MJE. Surgical volume and conversion rate in laparoscopic hysterectomy: does volume matter? A multicenter retrospective cohort study. Surg Endosc. 2018;32(2):1021-6.

Begum M, Zulfiqar N, Yasmin F. Total laparoscopic hysterectomy: a two-year experience in Apollo Hospitals Dhaka. Pulse. 2015;8(1):21-9.

Mereu L, Carlin R, Pellegrini A, Guasina F, Berlanda V, Tateo S. Total laparoscopic hysterectomy for benign disease: outcomes and literature analysis. Gynecol Surg. 2018;15(1):19.

Terzi H, Biler A, Demirtas O, Guler OT, Peker N, Kale A. Total laparoscopic hysterectomy: Analysis of the surgical learning curve in benign conditions. Int J Surg. 2016;35:51-7.

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. J Am Assoc Gynecol Laparosc. 2002;9(3):339-45.

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BJ, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015;8:CD003677.