Laparoscopic Hysterectomies: Our 10 Years Experience in a Single Laparoscopic Center

Abstract

Study Objective To evaluate the association between outcomes of laparoscopic hysterectomy with respect to clinical factors, intraoperative variants, and post-operative complications. Design The study conducted was retrospective (Canadian Task Force Classification II-1). Setting The set used in this study was a gynecological laparoscopic centre. Patients The present study included 858 women who underwent laparoscopic hysterectomies with or without bilateral/unilateral salpingo-oophorectomy, from December 2004 to May 2014. Interventions Eight hundred and sixteen patients underwent total laparoscopic hysterectomy, 14 patients underwent subtotal laparoscopic hysterectomy, 20 patients underwent laparoscopic-assisted vaginal hysterectomy, and 8 patients underwent laparoscopic radical hysterectomy with bilateral pelvic lymph node dissection. Measurements and Main Results All surgeries were performed by the same surgeon, using the same surgical technique. The medical records were reviewed, and data were collected with respect to age, indications, type of surgery performed, intraoperative variants, and post-operative complications. Patient average age was 44.9 ± 6.2 years. Most common indication for benign TLH was leiomyoma of 54.4 %. Indications for laparoscopic radical hysterectomy were early stage endometrial cancer (n = 5) and early stage cervical cancer (n = 3). The maximum uterine size operated on was from 20-26 weeks, 4.9 % (n = 42). 9.7 % had previous abdominopelvic surgery. Fifty three % 123 underwent unilateral/bilateral salpingo-oophorectomy. Conversion rate was 0.93 % (n = 8). The minimum and maximum operating time during the total study period was 20 min-2 h. The major complication rates were 0.9 % (n = 8). The hospital stay was not more than 2 days. Conclusion In our experience of 858 laparoscopic hysterectomies, 850 were done for benign indications, and 8 done for malignancies. TLH can be performed more safely and under vision, with less blood loss, early post-operative recovery, less post-operative infection, and less complication rate.

Total laparoscopic hysterectomy: a retrospective study of 5 years

“…8 This was much higher compared to the study by Bettaiah et al where it was 0.9%. 9 A complication rate of 4.5% was reported by O'Hanlan et al 10 Hoffman et al, had a major complication rate of 5.6%, while Heinberg et al, had a major complication rate of 14.4%, and Chapron reported complications in 10%. [11][12][13] Urological complication in the present study was 1 (0.84%) case of bladder injury.…”

“…Conversion rate reported by Bettaiah R et al was 0.93% and Vaisbuch E et al was 1.8%. 9,26 Conversion rate of 10.9% was reported by Sinha R et al where conversion was required for intractable hemorrhage, bladder injury and inability to reach all pedicles. 27 There is similarity between this study and the present study regarding the reasons for conversion.…”

Laparoscopic assisted vaginal hysterectomy: an experience at a Fortis Escorts hospital

“…8 Ramesh et al reported fibroid (54.4%) to be the most common cause of hysterectomy. 9 The concomitant surgical procedures that were done with this LAVHs didn't prolong the operative time except in cases of vaginal repair. The same was noticed by other surgeon.…”

Case report of ovarian torsion mimicking ovarian cancer as an uncommon late complication of laparoscopic supracervical hysterectomy

“…According to recent publications the overall complication rate of all hysterectomy methods is about 1-4.5% depending on the source [ 6 – 9 ]. In one of the recent studies intraoperative complications in the abdominal group occurred in 7.4% of cases, followed by vaginal (3.9%) and laparoscopic (3.7%) groups [ 8 ].…”

“…In one of the recent studies intraoperative complications in the abdominal group occurred in 7.4% of cases, followed by vaginal (3.9%) and laparoscopic (3.7%) groups [ 8 ]. Other studies presented the hysterectomy conversion rate as 0.93% and the complication rate as 0.9% (mostly total laparoscopic hysterectomies) [ 9 ].…”