scholarly journals Comparison between Laparoscopic, Abdominal, and Vaginal Hysterectomy in the Treatment of Gynecological Disease: A Retrospective Review Over Five Years

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Bladder Injury ◽  
Estimated Blood Loss ◽  
Operative Complications ◽  
Gynecological Disease

Background: Hysterectomy is one of the most common gynecological surgery worldwide. It is usually performed through the abdominal, vaginal or laparoscopic routes. The objective of this study was to evaluate the role of laparoscopic, vaginal and abdominal hysterectomy in the management of gynecological conditions in terms of operative outcomes, such as operating time and estimated blood loss, as well as complication rates. Methods: This was a retrospective cohort study carried out over a 5-year period (2016-2020) at Zahraa University Hospital. Patients who underwent abdominal vaginal, and laparoscopic hysterectomies performed for the treatment of multiple gynecological disease during that period were included. Results: A total of 222 patients were included in the study, 168 (75.7%) patients in the abdominal hysterectomy group, 7 (3.2%) in the vaginal group, and 47 (21.1%) in the laparoscopic group. The mean age was 49.83±9.28 years for the abdominal, 67.14±13.79 for the vaginal, and 47.26±6.77 years for the hysterectomy groups. The most common indication for hysterectomy was the presence of uterine fibroids in the abdominal and laparoscopic groups (47.6% vs. 31.9% respectively) whereas it was pelvic organ prolapse for all patients in the vaginal group. Around 18% in the abdominal group had abnormal uterine bleeding compared to 6.4% in the laparoscopic group. Endometrial hyperplasia was the indication for 9.5% of the patients in the abdominal group while it was 25.5% for the laparoscopic group. Surgery duration was significantly the shortest for abdominal hysterectomy (2.30±0.92 hours), followed by vaginal hysterectomy (2.86±0.24 hours), and the longest was for laparoscopic hysterectomy (4.14±0.90 hours) (p-value<0.0001). The size of the uterus was slightly larger in the abdominal hysterectomy group though the difference was not significantly different. There were no significant differences in pre- and post-operative hemoglobin, or in estimated blood loss among the groups. There were no complications in the vaginal group. The rate of complications was similar between the abdominal and laparoscopic groups (15.5% vs. 17.0% respectively). The most common type of intraoperative complication in the abdominal group was bleeding requiring transfusion (34.6%), followed by bladder injury (11.5%). Only one patient in the laparoscopic group had intra-operative complication (bladder injury). As for post-operative complications, urinary retention and pyrexia related to wound infection were the most common in the abdominal group (7.7%). Seven patients in the laparoscopic group had post-operative complications. Most patients were readmitted to the hospital (98.8% vs. 100.0% vs. 95.7% in the abdominal vs. vaginal vs. laparoscopic groups respectively). Conclusion: Laparoscopic hysterectomy is associated with less morbidity, and shorter hospital stay than the other techniques, but it has longer operating time and requires laparoscopic instrument and surgical skills. Advances in equipment, surgical techniques, and training make laparoscopic hysterectomy an efficient and well-tolerated technique.

scholarly journals Laparoscopic Hysterectomy Versus Abdominal Hysterectomy of Enlarged Uterus

2020 ◽  
Vol 3 (1) ◽  
pp. 01-08
Author(s):  
Bassem Islam
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Estimated Blood Loss ◽  
Significant Difference

This prospective interventional to assess feasibility of total laparoscopic hysterectomy (LH) for uteri weighing 280 gm or more. The study included 120 patients divided to 60 patient conducted total laparoscopic hysterectomies and 60 patients conduct total abdominal hysterectomy as standard method. Full history taking, gynecologic examination and ultrasound examination were done to all patients. The following data were collected from every patient in all groups: Age, BMI, uterine weight, Operative time, Estimated intraoperative blood loss, Preoperative hemoglobin and postoperative hemoglobin deficit 12 hours after surgery, intraoperative and Post-operative complications, Time to resumption of bowel movements to normal, Length of hospital stay. The most common indication among our patients was fibroid uterus while adenomyosis came second. All operations were performed by the same surgeons and using the same technique. We observe BMI is not considering as obstacle in laparoscopic group with advancement of anesthesia and sealing system. The mean operating time was slightly but not significally lower in laparoscopic hysterectomy with highly significant difference in the estimated blood loss in favor of laparoscopic group. The total incidence of intra-operative and postoperative complication of patient submitted to laparoscopic hysterectomy lower than conventional hysterectomy group but not statically significantly. There was significant difference in pain scoring, earlier bowel movement and hospital stay in the arm of laparoscopic group.

scholarly journals A Comparative evaluation of Non-descent vaginal hysterectomy versus total Abdominal hysterectomy: A hospital based case control study

2019 ◽  
Vol 17 (1) ◽  
pp. 20-22
Author(s):  
Durga BC ◽  
Aseem Sharma ◽  
Binod Mahaseth ◽  
Nirmala Sharma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Benign Pathology ◽  
Operative Complications ◽  
Control Study ◽  
Post Operative Complications

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

scholarly journals Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy: A four years retrospective study in tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3596
Author(s):  
Namrata Vasant Padvi ◽  
Jitendra Pundalik Ghumare
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Operating Time ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Hospital ◽  
Intraoperative Complication ◽  
Estimated Blood Loss

Background: Hysterectomy is one of the commonest gynaecological operations performed in India. Traditional surgical treatments performed are abdominal hysterectomy and vaginal hysterectomy. Vaginal and laparoscopic procedures are considered “minimally invasive” surgical approaches because they do not require a large abdominal incision and, thus, typically are associated with shortened hospitalization and postoperative recovery times compared with open abdominal hysterectomy. With the aid of laparoscopic procedure, a potential abdominal hysterectomy can be converted to a vaginal one and a difficult vaginal hysterectomy can be converted into a fairly simple vaginal hysterectomy. Aim of the present study is to compare above methods of hysterectomy in terms of operating time, estimated blood loss, and postoperative hospital stay and complication, so as to provide best course of treatment to patient.Methods: A retrospective observational study was conducted in tertiary care centre. Four-year data was collected from January 2012 to December 2016. Cases of LAVH with benign gynaecological condition and up to 12 weeks size uterus, without any associated medical condition were selected in study randomly, and compare with cases of NDVH, TAH in terms of duration of operative procedure, blood loss during surgery, and postoperative hospital stay.Results: In present study we found that average duration of procedure in LAVH was 84.35 minute, which was maximum compare to other method. Estimated blood loss in LAVH was least as compare to NDVH and TAH it was maximum. The average hospital stays in LAVH and NDVH was less as compared to TAH.Conclusions: LAVH should be considered a better approach in view of the relatively less blood loss and intraoperative complication. Due to lack of large randomized controlled trials, the role of Laparoscopic hysterectomy is difficult to define.

scholarly journals Comparative Study of Non-descent Vaginal Hysterectomy with Total Abdominal Hysterectomy

2021 ◽  
Vol 17 (3) ◽  
pp. 220-226
Author(s):  
Rubina Shrestha ◽  
Subha Shrestha ◽  
Satindar Ray
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Medical Science ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Complications ◽  
Hospital Stays ◽  
Post Operative Complications

IntroductionHysterectomy is the most common operation performed by gynecologist worldwide. In the present era emphasis is given on minimal invasive surgery so Non-Descent Vaginal Hysterectomy (NDVH) has gained more interest over Total abdominal Hysterectomy (TAH). NDVH has several benefits over TAH in terms of blood loss, operating time, post-operative complications, recovery and hospital stays. The objective of the study was to compare the clinical outcome of NDVH over TAH with respect to operating time, blood loss, hospital stays, intraoperative and early postoperative complication and to find out the most efficient route for hysterectomy.  MethodsThe study was conducted at College of Medical Science-Teaching Hospital, Bharatpur, Chitwan, Nepal between May 2017- May 2020. Fifty cases each of NDVH and TAH group fulfilling the selection criteria were included in the study. Outcome was measured on the basis of operating time, blood loss, hospital stay and intra an d post-operative complications.  ResultsBaseline characteristics were similar between both the groups. The most common indicationfor hysterectomy in both the group was fibroid uterus. There was no intra-operativecomplication in NDVH group but in TAH group bowel injury was encountered in 3 cases.The operating time, blood loss, hospital stay and post-operative complications were less inNDVH as compare to TAH ConclusionsNDVH is the better choice of surgery than TAH for the non-prolapsed uterus, size less than12 weeks with benign pathology.

scholarly journals Assessment of the learning curve: total laparoscopic hysterectomy versus total abdominal hysterectomy

2019 ◽  
Vol 8 (10) ◽  
pp. 4045
Author(s):  
Nutan Yadav ◽  
Priyanka Tiwari ◽  
Abhishek Mangeshikar ◽  
Sushil Kumar
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Success Rates ◽  
Estimated Blood Loss ◽  
The Mean

Background: Abdominal hysterectomy is the most frequented way of hysterectomy in the world; today we have a lot of techniques for hysterectomy. Total Laparoscopic Hysterectomy (TLH) versus Total Abdominal Hysterectomy (TAH) needs experience an assessment of the learning curve. Objective of the study was to determine the feasibility and safety of TLH and TAH.Methods: Total 100 women were taken for study. Operating time, estimated blood loss, operating complication and length of stay in hospital were noted for each patient. The success rates of TLH were more compared to TAH. The operating time estimated blood loss, conversion to laparotomy was directly proportional to size of uterus.Results: There were no statistically significant differences between the two groups regarding age, body mass index (BMI), specimen weight, pre-operative hemoglobin (Hb) value and rates of the complications. The mean post-operative Hb value was significantly higher in group TLH than group TAH (11.3±0.7 gr/dl versus 10.6±1.6, p = 0.03). The mean time of operation was significantly longer in TLH than group TAH (105.4±22.9 minutes versus 74±18, p<0.001). The mean duration of hospital stay was statistically shorter in TLH compared to the TAH (2.47±0.5 days versus 4.86±1.1, p<0.001).Conclusions: Advantage of TLH over TAH are less blood loss, fewer wound infection and fever, smaller incisions, with less pain, shorter hospitalization time, speedier recovery.

Total laparoscopic hysterectomy versus total abdominal hysterectomy for obese women with endometrial cancer

2005 ◽  
Vol 15 (2) ◽  
pp. 319-324 ◽  
Author(s):  
A. Obermair ◽  
T. P. Manolitsas ◽  
Y. Leung ◽  
I. G. Hammond ◽  
A. J. Mccartney
Keyword(s):  
Endometrial Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Intention To Treat ◽  
Estimated Blood Loss

Obesity is common in endometrial cancer and surgery for these patients is challenging. We compared total laparoscopic hysterectomy (TLH) with total abdominal hysterectomy (TAH) with respect to feasibility (operating time, estimated blood loss, length of hospital stay, and conversion to laparotomy) and safety (perioperative morbidity and mortality) in a retrospective analysis of 78 morbidly obese patients with endometrial cancer. Analysis is based on the intention to treat. The intention to treat was TLH in 47 patients and it could be successfully completed in 42 patients (89.4%). The mean weight for all patients was 118.7 kg, with patients in the TLH group weighing more and having higher ASA scores. Mean operating time and estimated blood loss were similar in both groups. Mean postoperative hospital stay was 4.4 (±3.9) days in the TLH group and 7.9 (±3.0) days in the TAH group (P < 0.0001). Wound infections occurred in 15 of 31 patients (48.4%) in the TAH group and in 1 of 47 patients (2.1%) in the TLH group. All other morbidity, as well as patterns of recurrence and survival were similar in both groups. These data justify a prospective randomized trial comparing TLH with TAH for the treatment of endometrial cancer

scholarly journals Total laparoscopic hysterectomy: a retrospective study of 5 years

2019 ◽  
Vol 8 (12) ◽  
pp. 5008
Author(s):  
Suma S. Moni ◽  
Suchith Hoblidar ◽  
Rathnamala M. Desai ◽  
Sunil Kumar K. S.
Keyword(s):  
Retrospective Study ◽  
Demographic Data ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Medical Sciences ◽  
Operative Specimen ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Findings

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.

scholarly journals COMPARATIVE ANALYSIS OF NON-DESCENT VAGINAL HYSTERECTOMY VERSUSTOTALABDOMINAL HYSTERECTOMY IN BENIGN UTERINE DISORDERS AT DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Suchandra Suchandra ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Postoperative Complications ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Early Mobilization ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Invasive Technique ◽  
Group A ◽  
Group B

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descentuterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus. Methods: The study was conducted in the Department of Obstetrics Gynaecology for a period of 18months at Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy andlabelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It wasseen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients. Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

scholarly journals LAPAROSCOPIC HYSTERECTOMY

2016 ◽  
Vol 23 (02) ◽  
pp. 166-170
Author(s):  
Zohra Kahnum ◽  
Amna Kahnum ◽  
Aman ur Rehman ◽  
Liaqat Ali
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Minimal Invasive ◽  
Safe Procedure ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Proper Training ◽  
Laparoscopic Assisted ◽  
Routine Procedures

Introduction: In current era, the trend for minimal invasive surgery is increaseddue to its established advantages. With the same, there increasing trend for laparoscopichysterectomy. But it carries certain risks in certain situations. Objectives: The study wasconducted to see the outcome of laparoscopic hysterectomies. Study Design: Retrospective,analytic study. Study Period: June 2012 to May, 2015. Method: A study was conducted to reviewthe outcome of Laparoscopic hysterectomy over a period of three years from June 2012 to May2015. Total one hundred cases were included in the study. These patients had hysterectomyeither total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy. Afterpreoperative evaluation, hysterectomy was done either total laparoscopic or laparoscopicassisted vaginal hysterectomy. Data was collected regarding patients profile variables,indications for hysterectomy, intraoperative findings, intraoperative time, postoperative recoveryfindings, analgesia requirements and discharge time from the hospital. Results: Results of thestudy showed that there was no significant increase in complication of urinary tract or bowelinjury. Operative time was decreased with time. Most common indication for hysterectomywas fibroid uterus or dysfunctional uterine bleeding. Patient recovery was smooth and postoperativeanalgesia was much less as compared to the routine. Patient hospital stay was lessas compared to the routine procedures for hysterectomy. Conclusion: It is concluded fromthe study that laparoscopic hysterectomy is safe procedure with the clear advantages for thepatient. In the study complication rate, operating time was comparable to the already publishedstudies. With proper training it is acceptable alternate to abdominal hysterectomy with clearadvantages for the patient.

scholarly journals Trends and patterns in total laparoscopic hysterectomy in tertiary care hospital

2018 ◽  
Vol 7 (6) ◽  
pp. 2170
Author(s):  
Sonali Ingole ◽  
Sameer Darawade
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Care Hospital ◽  
Estimated Blood Loss ◽  
The Mean

Background: Due to technical advances in the field of laparoscopy, there has been an increase in total laparoscopic hysterectomies all over the world in last decade. This study was conducted to analyse the technique and surgical outcome of total laparoscopic hysterectomy in tertiary care hospitalMethods: This is a retrospective cohort (observational) study, which included all patients who underwent Total Laparoscopic Hysterectomy (TLH) for benign conditions from January 2012 to December 2017 at the tertiary Care Hospital. The data so obtained was analysed for various parameters like indication for surgery, mean operating time, length of hospital stay, complications and conversion to abdominal route.Results: Total number of 2307 hysterectomies were performed over a period of 5 years. Of these, TLH were 270 (11.70%). Amongst those undergoing TLH, the mean age was 45±7.84 years. The most common indication for the surgery was fibroid uterus (38.14%), followed by dysfunctional uterine bleeding (28.88%), and adenomyosis (15.1%). The mean estimated blood loss was 106±4.34 ml. Hemorrhage (n = 2) and bladder injury (n = 4) were most common surgical complications.Conclusions: TLH is safe and effective procedure for most of the benign pelvic conditions. With adequate training TLH can be used more widely in tertiary care hospital and teaching institute.

Sign in / Sign up

Export Citation Format

Share Document