scholarly journals Comparison of Different Surgical Approaches for Hysterectomy: A Single-Institution Experience

2018 ◽  
pp. 1
Author(s):  
Yusuf Aytac Tohma ◽  
Mehmet Tunc ◽  
Emre Gunakan ◽  
Irem Kucukyildiz ◽  
Latife Atasoy Karakas ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Single Port ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Single Institution ◽  
Single Port Access ◽  
Port Access ◽  
Significant Difference ◽  
Duration Of Surgery

<p><strong>Objective:</strong> We aimed to compare surgical outcomes and postoperative complications among different hysterectomy approaches such as total abdominal hysterectomy, vaginal hysterectomy, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy.</p><p><strong>Study Design:</strong> This retrospective, single institution, case control study was carried out at the Obstetrics and Gynecology Department of Baskent University in Ankara, Turkey. We evaluated 86 consecutive patients who underwent hysterectomy for benign gynecological conditions.</p><p><strong>Results:</strong> A total of 86 women underwent hysterectomy: 20 (23.3%) total abdominal hysterectomy, 20 (23.3%) vaginal hysterectomy, 27 (31.3%) multiport access laparoscopic hysterectomy, and 19 (22.1%) single-port access laparoscopic hysterectomy using a transumbilical single-port system. There was no significant difference in uterine size between groups (Z=5.705; p=0.127). A statistically significant (p&lt;0.001) difference in operation time (duration of surgery) was observed among the following groups. The duration of surgery for the multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups was similar, with these two laparoscopic procedures requiring significantly more time than total abdominal hysterectomy and vaginal hysterectomy procedures. There was no statistically significant difference in between hemoglobin levels before and after operation between groups. There was no statistically significant difference between groups in intraoperative and postoperative complications. Six patients experienced complications, one intraoperative and five postoperative. Intraoperative complication was ureter injury in single-port access laparoscopic hysterectomy group. The postoperative complication rate was 5.8% (5 cases) in 86 patients. Perirectal abscess in one patient and wound infection in two patients occurred in total abdominal hysterectomy group (15%). Urinary tract infection in one patient and vaginal cuff cellulitis in one patient occurred in vaginal hysterectomy group (4%). No complications were reported in multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups. Post-surgery, all patients who underwent single-port access laparoscopic hysterectomy reported that they were satisfied with their incision and cosmetic results.</p><p><strong>Conclusions:</strong> When technically feasible, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy may be performed instead f total abdominal hysterectomy because of rapid recovery and shorter hospitalization however there are longer operating time.</p>

scholarly journals Indications and types of hysterectomy in the National Referral Hospital of Bhutan, 2020

2021 ◽  
Vol 7 (2) ◽  
pp. 19-23
Author(s):  
Namkha Dorji ◽  
Kencho Zangmo ◽  
Sangay Tshering ◽  
Renuka Mongar ◽  
Sonam Sonam
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Skin Incision ◽  
Referral Hospital ◽  
Gynecological Surgery ◽  
Duration Of Surgery ◽  
National Referral Hospital

Introduction: Hysterectomy, the removal of uterus, is a major gynecological surgery performed in Bhutan. It is performed for both benign and malignant gynecological conditions. This study was conducted to assess the socio-demographic profiles, types of hysterectomies and their indications, and duration of surgery and duration of peri-operative hospital stay among women who had hysterectomy at the national referral hospital of Bhutan.  Method: This was a retrospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital, Thimphu. Data of women, who had hysterectomy from 1st January to 31st December, 2020 was extracted into a structured questionnaire by investigators from the patients record maintained at the record section, JDWNRH. Ethical approval was sought from the Research Ethics Board of Health. Data were entered into EpiData 3.1 and was analyzed using descriptive commands of STATA 13.1 Result: Hysterectomy comprised of 9.8% of gynecological surgery in 2020. The commonest route of approach was total abdominal hysterectomy which comprised of 81.7% of hysterectomies. It was found out that 92.9% of hysterectomies were performed under general anesthesia and 97.4% of the surgeries were done as elective or planned cases. The mean (+SD) duration of surgery from skin incision to closure was shortest for vaginal hysterectomy (68.8 + 17.6 minutes) and longest for total laparoscopic hysterectomy (210 + 35.2 minutes). The duration of peri-operative hospital stay was shortest for vaginal hysterectomy. Conclusion: Total abdominal hysterectomy was the common approach despite vaginal hysterectomy being performed under regional anesthesia with shorter duration of surgery and shorter hospital stays.

scholarly journals TLH versus TAH: a 2 year retrospective comparative study

2019 ◽  
Vol 8 (10) ◽  
pp. 3939
Author(s):  
Anju Dogra ◽  
Vinay Kumar ◽  
Nishu Bhushan
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Wound Infection ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.

scholarly journals Single-Port Access Laparoscopy-Assisted Vaginal Hysterectomy: Our Initial Experiences with 100 Cases

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Young-Sam Choi ◽  
Kwang-Sik Shin ◽  
Jin Choi ◽  
Ji-No Park ◽  
Yun-Sang Oh ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Single Port ◽  
Bladder Injury ◽  
Safe Procedure ◽  
Single Port Access ◽  
Laparoscopically Assisted Vaginal Hysterectomy ◽  
Single Port Surgery ◽  
Port Access ◽  
Pelvic Hematoma ◽  
Port System

Objectives.To present our initial experiences with laparoscopically assisted vaginal hysterectomy performed using homemade transumbilical single-port system.Materials and Methods.We reviewed the medical records of one hundred patients who underwent single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH). SPA-LAVH was performed with homemade single port system and conventional rigid laparoscopic instruments.Results.All procedures were successfully completed through the single-port system and vagina without need for extraumbilical puncture or conversion to laparotomy. The median patient age was 48.2 ± 6.5 years. Thirty-three patients had history of past abdominopelvic surgery. The median total operative time, largest dimension of the uterus, and weight of the uterus were 73.1 ± 24.6 min, 10.5 ± 2.1 cm, and 300.8 ± 192.5 gram, respectively. The median decline in the hemoglobin from before surgery to postoperative day 1 was 1.8 ± 0.9 g/dL. Bladder injury in occurred one patient who was repaired through intraoperative laparoscopic suture. The postoperative course was uneventful in most patients except for three who had a transient paralytic ileus, five who had pelvic hematoma, but they were recovered following conservative managements. No port-related complications were noted, and the cosmetic results were excellent.Conclusions.SPA-LAVH is technically safe procedure, and the homemade single-port system offers reliable access for single-port surgery.

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