The gynecologic patient benefits from early discharge in many ways. A growing evidence of literature suggests that same-day discharge is safe for minimally invasive hysterectomy for benign indications.The primary outcome was the acceptability rate of early discharge after informing patients that if they wish they can be discharged from the hospital within 24 hours or they might stay longer. The secondary outcomes were to evaluate the 30 day emergency department and hospital readmission rates between same-day discharge and delayed discharge after laparoscopic hysterectomy in an academic referral centre. Material and Methods: This is an observational non-randomised prospective clinical trial. Patients who underwent laparoscopic hysterectomy at an hospital deemed "fit for discharge" were evaluated. Variables including patient comorbidities and other details were prospectively collected for each patient. Postoperative outcomes were followed for 30 days following the operation utilizing the hospital's central medical record system.All patients were scheduled for postoperative 1 month control to account for any other hospital visits or admissions besides our centre. Results: From October 2021 to April 2022, a total of 275 laparoscopic hysterectomies were performed at our department. After exclusion criteria 194 patients were deemed fit for discharge using a check-list. 96 (49.5 %) of these preffered to be discharged before 24 hours while the slight majority of 98 patients (50.5 %) opted to stay over 24 hours. The groups were similar with regards to age, BMI, clinical and surgical characteristics. The only effective variable reaching statistical significance between the two groups was the duration of the operation. Our readmisson rate was 1.04 % in the early discharge group and 1.02 % in the late discharge group. Conclusion: Duration of surgery was the sole variable effecting patient preference of early discharge. There was no difference in complications or 30-day emergency department visits in either group. Even though it was considered safe to be early discharged to home, as evident by low complication and readmission rates, more than half of our patients did not prefer to do so. Promoting nursing staff and home based visits may increase the acceptability of early discharge.

Most of the first line cerclage operations are performed by transvaginal route, TAC (Transabdominal Cerclage) is the surgical procedure of choice in cases with transvaginal cerclage failure or short cervix due to excisional procedures. In this report, we are presenting two cases of TAC operation in which uterine manipulation was provided with a novel atraumatic method. Broad ligament of the uterus was dissected from both anterior and posterior aspects and trans-ligamentary windows were created bilaterally. Bilateral Penrose drains were passed through windows on the broad ligament elevating and retroflexing the uterus. The broad ligament window was extended down to the uterovesical fascia and the bladder was rejected with sharp dissection.Double-needled, 5mm mersilene tape suture was passed through the cervical stroma from posterior to anterior direction bilaterally and tied on the anterior cervical surface. Our novel modification to TAC may have a potential role in advanced pregnancies.