scholarly journals Comparison of total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy – a 2-year retrospective study

Author(s):  
Kanmani Mani ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj

Background: Hysterectomy is one of the most commonly performed major surgeries. Recently, increasing number of minimally invasive approaches, such as TLH and LAVH has been applied. People undergoing laparoscopic hysterectomy experience shorter hospitalization, a smaller wound, more rapid recovery, and shorter absence from work compared to patients undergoing abdominal hysterectomy. The objective of present study is to compare the surgical short term results between Laparoscopic assisted vaginal hysterectomy (LAVH) and Total laparoscopic hysterectomy (TLH) in our centre in two years.Methods: This was a retrospective study of 93 women who underwent LAVH and 55 women who underwent TLH. The statistical analysis is done by using Students t-test, Chi-square test, and Mann-Whitney test appropriately.Results: There were no differences between the two groups with respect to age, BMI, Indication of surgery, Uterine size, Previous pelvic surgery, average blood loss and hemoglobin change (P=0.4). The duration of surgery was longer in TLH (124 min vs. 76.9 min) and is found to be extremely significant (P=0.0001). There was significant statistical difference in respect to hospital stay (P=0.0076). There was no significant statistical difference in various complication rates (P=0.22).Conclusions: Both TLH and LAVH are safe methods in performing hysterectomy, but LAVH has advantages over TLH with reduced operating time and less hospital stay even for the patients with history of previous pelvic surgery.

Author(s):  
Kanmani M. ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj

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.


Author(s):  
Neelu Rajput ◽  
Sahab Singh Yadav ◽  
Pratibha Narwade

Background: The objective of this study was to evaluate the laparoscopic assisted vaginal hysterectomy (LAVH) in terms of demographic data of patients, indications, uterine size, intraoperative and postoperative complications, amount of blood loss, operative time and duration of hospital stay.Methods: A retrospective study was conducted on 160 cases, who underwent laparoscopic assisted vaginal hysterectomy in the period between October 2018 to November 2019 at the Fortis Escorts Hospital, Faridabad, Haryana, India.Results: Majority of patients (58.75%) belongs to age group between 40-50 year. Only 30.62% cases had a history of one previous abdomino-pelvic surgery. Majority of cases (52.5%) in the study group had uterine size between 6-12 weeks. Most common indication of hysterectomy in this study was fibroid uterus which account for 49.37% of cases followed by dysfunctional uterine bleeding (16.87%) cases. Mean time of surgery in this study was 114.4±0.59 min and average blood loss was 135.62±47.63 ml. The mean weight of uterus was 243.75±82.94 gm. 5% cases had major intraoperative complications while minor postoperative complications were seen in 16.87% cases. Bladder injury was seen in 1.25%. Major haemorrhage occur in 1.25%. In this study conversion to laparotomy rate was 1.25%. Only one case of ureteric injury and one case of bowel injury was noted. Among minor complications fever (6.25%) and urinary tract infection (5.62%) were mainly seen. Mean duration of hospital stay was 2.82±1.17 days.Conclusions: LAVH enables the surgeon to convert most of the abdominal hysterectomies into vaginal ones and hence decreases postoperative pain, decreases complications, lesser duration of hospital stay and rapid return to normal activity.


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