Total Laparoscopic Hysterectomy Versus Vaginal Hysterectomy: A Systematic Review and Meta-Analysis

Sandberg, Evelien M.; Twijnstra, Andries R. H.; Driessen, Sara R. C.; Jansen, Frank Willem

doi:10.1016/j.jmig.2016.10.020

Cited by 93 publications

(92 citation statements)

References 41 publications

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“…The risk of urinary tract injury has historically been cited as higher in the laparoscopic approach; however, a 2015 Cochrane systematic review and various retrospective studies did not demonstrate any difference between LH and VH with respect to complications, blood loss, urinary tract injuries, patient satisfaction or sexual function after surgery. Recent data also support shorter length of hospital stay after LH, along with decreased postoperative pain . In favor of the laparoscopic approach are the recent guidelines from the Society of Gynecologic Oncology which state that opportunistic salpingectomy is an appropriate and feasible strategy for ovarian cancer risk reduction, as concomitant adnexal surgery may be less likely to take place at the time of VH …”

Section: Introductionmentioning

confidence: 99%

“…Recent data also support shorter length of hospital stay after LH, along with decreased postoperative pain . In favor of the laparoscopic approach are the recent guidelines from the Society of Gynecologic Oncology which state that opportunistic salpingectomy is an appropriate and feasible strategy for ovarian cancer risk reduction, as concomitant adnexal surgery may be less likely to take place at the time of VH …”

Section: Introductionmentioning

confidence: 99%

“…If a vaginal approach is not feasible, then laparoscopic hysterectomy (LH) is preferred. [1][2][3][4][5][6] In addition to ACOG, the American Association of Gynecologic Laparoscopists and the Royal College of Obstetricians and Gynaecologists support both the vaginal and laparoscopic approaches to hysterectomy as minimally invasive alternatives to reduce surgery-related morbidity of a laparotomic approach. 2,6 Despite these recommendations, the laparoscopic approach is gaining popularity while rates of VH remain stagnant.…”

Section: Introductionmentioning

confidence: 99%

“…7 The most frequently cited differences between VH and LH are a shorter operative time and lower cost in the vaginal approach. [3][4][5]8,9 The risk of urinary tract injury has historically been cited as higher in the laparoscopic approach; however, a 2015…”

Section: Introductionmentioning

confidence: 99%

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Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score‐matched analysis

Rademaker

Einarsson

Huirne

et al. 2019

Acta Obstet Gynecol Scand

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Introduction There are assertions that vaginal mode may be the preferred approach of minimally invasive hysterectomy, yet rates of laparoscopic hysterectomy (LH) continue to rise while vaginal hysterectomy (VH) rate remains relatively unchanged. The aim of this study is to compare the perioperative outcomes of LH vs VH. Material and methods We identified women who underwent either LH or VH for benign indications between 2009 and 2015 at a large academic institution. A propensity score‐matched analysis was used to adjust for differences between women undergoing VH vs LH. Outcome parameters were perioperative complications (both intraoperative and postoperative), operative time, blood loss, hospital length of stay, conversion and readmission. Results A total of 1921 patients underwent either LH or VH during the study period. In all, 155 patients from each group were successfully matched using propensity score match analysis. While most intra‐ and postoperative characteristics did not differ between groups, LH was associated with lower blood loss during surgery (102.8 ± 166.5 mL vs 185.0 ± 179.0 mL, P < 0.001) and shorter hospital stay (0.9 ± 1 days vs 1.2 ± 0.9 days, P < 0.0001). Concomitant adnexal surgery was performed more frequently during LH (47.7% vs 12.3%, P < 0.0001), and concomitant prolapse surgery was performed more frequently at the time of VH (14.2% vs 68.4%, P < 0.0001). Conclusions Both VH and LH have overall favorable perioperative outcomes; however, LH is associated with lower blood loss and a shorter hospital stay. The results support the trend toward increasing rates of laparoscopic approach to hysterectomy when appropriate.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score‐matched analysis

Rademaker

Einarsson

Huirne

et al. 2019

Acta Obstet Gynecol Scand

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“…Currently, benign diseases such as fibroids, adenomyosis, and endometrial polyps can undergo hormonal treatment, but many gynecologic diseases still require surgery. [9] …”

Section: Introductionmentioning

confidence: 99%

Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy

Rodrigues¹,

Rodrigues

Freitas

et al. 2019

Medicine

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Background: Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while seated at a console in the operating room. This differs from laparoscopic hysterectomy because a “robot” performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery. Methods: We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review will include studies reporting use of QOL metrics to assess patients who undergo total hysterectomy for benign indications using robotic-assisted technique or conventional laparoscopic surgery. QOL will be the primary outcome and will be measured using validated instruments. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least 2 trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence will be determined using the GRADE approach. Results: This systematic review is designed to provide high quality evidence on QOL in patients undergoing total hysterectomy for benign indications using either robotic-assisted or conventional laparoscopic surgery. Conclusion: It is expected that high-quality evidence on QOL can be used to guide decision-making by institutions and clinicians to improve health care; the evidence can also be used in future studies. PROSPERO registration number: PROSPERO CRD 42019129913

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Surgical approach to hysterectomy for benign gynaecological disease

Pickett,

Seeratan,

Mol

et al. 2023

Cochrane Database of Systematic Reviews

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BackgroundThe four approaches to hysterectomy for benign disease are abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopic hysterectomy (LH) and robotic-assisted hysterectomy (RH). ObjectivesTo assess the effectiveness and safety of different surgical approaches to hysterectomy for women with benign gynaecological conditions. Search methodsWe searched the following databases (from inception to 14 August 2014) using the Ovid platform: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. We also searched relevant citation lists. We used both indexed and free-text terms. Selection criteriaWe included randomised controlled trials (RCTs) in which clinical outcomes were compared between one surgical approach to hysterectomy and another. Data collection and analysisAt least two review authors independently selected trials, assessed risk of bias and performed data extraction. Our primary outcomes were return to normal activities, satisfaction, quality of life, intraoperative visceral injury and major long-term complications (i.e. fistula, pelvi-abdominal pain, urinary dysfunction, bowel dysfunction, pelvic floor condition and sexual dysfunction).

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Total Laparoscopic Hysterectomy Versus Vaginal Hysterectomy: A Systematic Review and Meta-Analysis

Cited by 93 publications

References 41 publications

Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score‐matched analysis

Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score‐matched analysis

Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy

Surgical approach to hysterectomy for benign gynaecological disease

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