scholarly journals The total laparoscopic hysterectomy - a modern route of hysterectomy. Is there a benefit?

2005 ◽  
Vol 54 (5S) ◽  
pp. 24a-24a
Author(s):  
В. Holthaus ◽  
A. Kletsel ◽  
А. Mosel ◽  
R. A. Regidor
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Short Hospital Stay ◽  
Female Patients ◽  
Benign Disorders

Objective: Total laparoscopic hysterectomy - a suitable approach to hysterectomy compared to the abdominal way. Introduction.Hysterectomy is the most frequent surgery performed on female patients (approximately 70,000 per year in Germany). In more than 90% of the cases, it is indicated for benign disorders. In 1996 about 8% of the operation were done by laparoscopy, in 2002 it was done in about 12% of the cases. Only a very few recent publications focuses on per- and postoperative complications of the total laparoscopic hysterectomy. The advantage of the laparoscopic approach has been mainly associated with a short hospital stay and a quick convalescence. The object of this study was to list the advantage and the complications of the laparoscopic hysterectomy.

scholarly journals Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy

2014 ◽  
Vol 9 (1) ◽  
pp. 26-28
Author(s):  
R Shrestha ◽  
LH Yu
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Short Hospital Stay ◽  
Early Recovery ◽  
Duration Of Hospital Stay ◽  
Operative Recovery

Aims: Hysterectomy can be performed by abdominal, vaginal and laparoscopic methods. Laparoscopic hysterectomy has been reported as an alternative to traditional abdominal hysterectomy with benefit of early recovery, short hospital stay and less operative complications. This study compared laparoscopic versus abdominal hysterectomy in terms of surgery time, blood loss, post-operative recovery, and duration of hospital stay. Methods: This is a retrospective comparative study among sixty patients who underwent laparoscopic or abdominal hysterectomy for various indications in the Department of Obstetrics and Gynaecology of the Third affiliated hospital of Zhengzhou University from January to March 2007. The data of the patients meeting the set criteria were obtained from the hospital records and hospital based computerized coding system. Enrolled cases were divided in two groups with thirty in each arm. Group TLH (total laparoscopic hysterectomy) was designated for patients who underwent total laparoscopic hysterectomy and group TAH (total abdominal hysterectomy) for those who underwent total abdominal hysterectomy. Results: There was comparatively less blood loss in TLH group (60.2±5.17 ml versus 75.7±7.12 ml) but it was statistically insignificant (p=0.12). The laparoscopic hysterectomy took longer time (107.6±32.4 min versus 74.9±31.1 min) than the abdominal (p<0.001). There was early recovery among TLH group 1.6±0.6 days versus 2.1±0.5 days in TAH group (p=0.001). Mean duration of hospital stay was significantly shorter in TLH group 7.6±1.9 days versus 10.1±2.1 days in TAH group (p<0.001). Conclusions: Laparoscopic hyserectomy is an effective alternative to abdominal hysterectomy with the advantage of less intra-operative blood loss, fast recovery and short hospital stay. DOI: http://dx.doi.org/10.3126/njog.v9i1.11183 NJOG 2014 Jan-Jun; 2(1):26-28

scholarly journals African experiences of laparoscopic hysterectomy about a continuous series of 52 cases by the same practitioner: indications, surgical procedures and complications

2018 ◽  
Vol 7 (3) ◽  
pp. 789
Author(s):  
Koffi Abdoul Koffi ◽  
Kacou Edele Aka ◽  
Minata Fomba ◽  
Konan Seni ◽  
Apollinaire Horo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Average Length ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Continuous Series ◽  
Average Size ◽  
A Prospective Study

Background: Laparoscopy is a modern surgical technique that began in 1940 with Raoul Palmer. The present study aimed to analyse the results of a fifty-two-laparoscopic hysterectomy performed.Methods: A prospective study over a period of seven years from 1st January 2010 to 31st December 2015. A total of 52 patients who underwent a laparoscopic hysterectomy were recruited at the teaching hospital of Yopougon-Abidjan.Results: The mean age was 50.2 years (±3.9 years) (36-62 years). The average parity was 3. Few patients had undergone anterior pelvic surgery for either myomectomy or caesarean section. Uterine fibroid was the major surgical indication with a rate of 61.54%. The average size of the uterus was 12 cm (8-18 cm). Total hysterectomies type II and III with or without adnexectomy were essentially performed with rates of 28.85% and 32.69%, respectively. Sometimes it was associated with a lymphadenectomy or a colpo-suspension. The average length of a hysterectomy is 170 minutes (87-385 minutes). Four cases of laparo-conversions have been noted. Blood loss was approximately 95 ml (±12 ml) with a maximum of 300 ml. The complications were mainly two digestive wounds and a bladder fistula. The average length of hospital stay is three days apart from any complication.Conclusions: The laparoscopic approach is less painful, is associated with less blood loss, shorter hospital stay, faster recovery, fewer complications, and better care. A training period of surgeons associated with the equipment of the health structures is necessary to popularize this procedure surgical.

scholarly journals A multimodal concept for vaginal cuff closure by modification of the Bakay technique in total laparoscopic hysterectomy: a randomized clinical study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Üzeyir Kalkan ◽  
Kadir Bakay
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Controlled Study ◽  
Complication Rates ◽  
Vaginal Cuff ◽  
Total Operative Time ◽  
Vaginal Length ◽  
Vaginal Cuff Closure

Abstract Background The aim of this study was to compare the outcomes of modified Bakay technique (MT) to standard colpotomy (ST) and cuff closure in total laparoscopic hysterectomy (TLH). Methods This two-centre, randomized-controlled study included a total of 160 patients who were scheduled for TLH for benign diseases (ClinicalTrials.gov Identifier is NCT05080114 and the first posted date was 15/10/2021). The patients were allocated into two groups by a computer-based randomization programme as ST group and MT group. Total operative time, cuff closure time, length of hospital stay, intra- and postoperative complications according to the Clavien-Dindo classification, pre- and postoperative vaginal length, and patient satisfaction according to the Patient Global Impression of Improvement (PGI-I) questionnaire were assessed. Results Seventy-seven patients in the ST group and 80 patients in the MT group underwent TLH. The total operative time was significantly shorter in the MT compared to the ST (55.5 vs. 59 min, respectively; p = 0.001). The median total operative time for colpotomy, extraction of uterus, and vaginal cuff closure steps was 9 (range 6–12 in MT vs. 6 to 11 in ST) min in both groups. The median hospital stay was 2 (range 1–4) days in both groups. Intraoperative blood loss was not significantly different between the groups (90 mL in ST vs. 80 mL in MT; p = 0.456). The mean uterine weight for the ST group and MT group was comparable (258.6 ± 88.6 g vs. 232.9 ± 102.5 g, respectively; p = 0.107). The preoperative vaginal length was not significantly different between the groups (p = 0.502). The median postoperative vaginal length was significantly higher in the MT group compared to the ST group on Day 90 (8 cm vs. 7,5 cm, respectively; p = 0.001). The PGI-I questionnaire score on Day 90 postoperatively was 2 (range 1–5) in both groups (p = 0.636). The complication rates were similar between the groups (p = 0.230). Conclusion The MT can be safely performed in most of the cases requiring TLH with the advantages of vaginal cuff closure before the alteration of pelvic anatomy, support to primary healing of the vaginal cuff, and routine concomitant apical support.

scholarly journals Laparoscopic approach to hysterectomy

2013 ◽  
Vol 4 (2) ◽  
pp. 117-126
Author(s):  
Hakan Nazik
Keyword(s):  
Laparoscopic Approach ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Cost Effective ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Organ ◽  
Uterine Bleeding ◽  
Total Laparoscopic Hysterectomy ◽  
Uterine Leiomyomata

Modern laparoscopic surgery is widely used throughout the world as it offers greater advantages than open procedures. The laparoscopic approach to hysterectomy has evolved over the last 20 years. Hysterectomies are performed abdominally, vaginally, laparoscopically or, more recently, with robotic assistance. Indications for a total laparoscopic hysterectomy are similar to those for total abdominal hysterectomy, and most commonly include uterine leiomyomata, pelvic organ prolapse, and abnormal uterine bleeding. When hysterectomy is going to be performed, the surgeon should decide which method is safer and more cost-effective. This paper aims to make a review of the indications, techniques and advantages of laparoscopic hysterectomy as well as the criteria to be used for appropriate patient selection.

scholarly journals A comparative study of non-descent vaginal hysterectomy and total laparoscopic hysterectomy

2020 ◽  
Vol 9 (2) ◽  
pp. 777
Author(s):  
Vijay Kansara ◽  
Jaydeep Chaudhari ◽  
Ajesh Desai
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Pap Smear ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Significant Difference ◽  
Operative Complications ◽  
Post Operative Complications

Background: Hysterectomy is the second most common operation performed by the gynecologists, next only to caesarean section. Objective of the study was to compare fall in blood haemoglobin level, duration of operation, intra- and post-op complications between non-descent vaginal hysterectomy and total laparoscopic hysterectomy and establish the better method for hysterectomy in non-descent uterus.Methods: A retrospective comparative study of 90 hysterectomies was done from a period of May 2018 - April 2019 at GMERS Medical College and Hospital Sola, with 45 cases in group of non-descent vaginal hysterectomy (NDVH) and 45 in group of total laparoscopic hysterectomy (TLH). Demographic characteristics, co-morbid conditions, indications for surgery, operative time, intra- operative blood loss, post-operative analgesia requirements, post-operative hospital stay and post-operative complications were compared between both groups. Those patients having malignancy as diagnosed by Pap smear or by D and C were excluded from the studyResults: The most common age in both groups was 41-50 years. Adenomyotic uterus was the most common indication for surgery in both groups. The mean operative time in NDVH group was 45 min while it was 80 min in TLH group. p<0.001 suggested significant difference when operative time were compared between both groups. Both groups were similar in post-operative analgesia requirement and post-operative hospital stay. Post-operative complications were similar in both groups.Conclusions: In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, technology available in the hospital and preference of patient as well as surgeon.

scholarly journals A Comparative Study of the Influence of Body Mass Index on Clinical Outcomes of Total Laparoscopic Hysterectomy in Birat Medical College Teaching Hospital, Morang, Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1383-1387
Author(s):  
Bhanubhakta Neupane ◽  
Gyanendra Man Singh Karki ◽  
Hanoon P Pokharel ◽  
Prerana Dahal ◽  
Garima Bhandari
Keyword(s):  
Body Mass Index ◽  
Postoperative Complications ◽  
Body Mass ◽  
Teaching Hospital ◽  
College Teaching ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Medical College ◽  
Increased Risk ◽  
High Bmi

Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult. Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy. Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups. Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy. 

scholarly journals Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study

2018 ◽  
Vol 7 (3) ◽  
pp. 1019
Author(s):  
Kanmani M. ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Surgical Results ◽  
Significant Difference

Background: Since the introduction of Laparoscopic hysterectomy by Reich in 1989, it has become a widely accepted technique worldwide. The aim of the study was to compare the surgical results between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH).Methods: We conducted a retrospective study at Women’s center and hospitals between June 2014 to May 2016, 32 patients who underwent TAH and 55 patients who underwent TLH, were included.Results: We observed that there was no significant difference between the two groups in respect to patient's demographic characteristics, indication of surgery, uterine size, or with history of previous pelvic surgery. Duration of surgery was found to be longer in TLH than TAH (124±39.7 min vs. 104.7±39.8 min). The length of hospital stay was less in TLH than TLH (P-0.0001) and the amount of blood loss were also less in TLH than TAH (103±149 ml versus 243±210 ml). There was no significant difference in view of intra and post operative complications. Hemoglobin change was statistically significant and is more with TAH than TLH (1.57±0.7g% versus 1.12±0.7g%).Conclusions: This study showed that TLH can be safely performed by the experienced surgeon in order to reduce the blood loss, duration of hospital stay and the quality of life.

scholarly journals Total laparoscopic hysterectomy in the grossly enlarged uterus

2005 ◽  
Vol 54 (5S) ◽  
pp. 20a-21a
Author(s):  
R. Botchorishvili ◽  
B. Rabischong ◽  
К. Jardon ◽  
J. L. Pouly ◽  
G. Mage ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Size Limitation ◽  
Recovery Times ◽  
Large Uterus ◽  
Laparoscopic Assisted

Introduction: Avoiding laparotomy by performing laparoscopic hysterectomy, of various types, has been shown to be beneficial in a number of ways. Shorter recovery times, shorter length of hospital stay and convalescence period, and earlier return to work than after abdominal hysterectomy are some of the positive factors cited. However, it is often considered that there is a size limitation of 14-16 weeks gestation to the feasibility of laparoscopic hysterectomy. Whilst a number of studies have shown that the laparoscopic-assisted vaginal hysterectomy (LAVH) successfully manages the large uterus, little has been published regarding a total laparoscopic approach.

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