A Comparative Overview of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy

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A Comparative Overview of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy

August 19, 2021 Medicine and Medical Science 0

Hysterectomy is a gynaecological procedure used to treat benign conditions like uterine leiomyoma, dysfunctional uterine bleeding, endometrial hyperplasia, dysmenorrhea, dyspareunia, and severe endometriosis that have failed to respond to medical or conservative surgical treatment, as well as malignant conditions like cervical, endometrial, and ovarian cancer. Abdominal, vaginal, and laparoscopic hysterectomy are all options. The most common procedure is abdominal hysterectomy, but it is more intrusive and is associated with more blood loss, a longer recovery time, and a longer hospital stay. Laparoscopic hysterectomy has become a generally accepted treatment around the world since Reich’s introduction in 1989. When compared to laparotomy, laparoscopic hysterectomy was found to have lower postoperative morbidity, greater quality of life, shorter hospital stay, and less blood loss. The study’s goal was to assess the surgical outcomes, as well as intra- and post-operative complications, of Total Laparoscopic Hysterectomy (TLH) versus Total Abdominal Hysterectomy (TAH) (TAH). Between October 2016 and September 2018, a retrospective study was undertaken at SMGS hospital, GMC Jammu, with a total of 252 patients participating. Patients were separated into two groups, each with 126 patients: Group A included patients who had TLH and Group B included patients who had TAH. We found no significant differences between the two groups in terms of patient age (45.164.58 against 45.236.44), parity (4.322.08 versus 4.773.18), or surgical indication. The operation time in TLH (116.0216.38) was observed to be longer than in TAH (83.1821.40). The time spent in the hospital was much shorter in TLH than in TAH ( p value 0.0001). The TAH group had a higher Hb decline than the TLH group (1.460.64 versus 1.830.68). TAH patients received 25 (19.8%) post-operative blood transfusions, whereas TLH patients received only 9 (7.14%) post-operative blood transfusions, a statistically significant difference (p value0.0001). The time to ambulation in TLH patients was significantly less than in TAH patients (9.944.29 versus 23.031.28). In TAH, wound infection was more common than in TLH; 5 patients had wound infection, and 4 had wound dehiscence that required suturing. Due to adhesions, vascular injury, and bowel injury in one case, laparoscopy was switched to laparotomy in eight patients. An skilled surgeon can safely perform TLH as an alternative to abdominal hysterectomy, according to this study. It provides a number of benefits over TAH, including a smaller incision, earlier ambulation, a shorter hospital stay, and a quicker recovery time, as well as the lack of more serious problems.

Author (S) Details

Anju Dogra
Department of Obstetrics and Gynaecology, SMGS Hospital, Government Medical College, Jammu, J&K, India.

Vinay Kumar
Department of Obstetrics and Gynaecology, SMGS Hospital, Government Medical College, Jammu, J&K, India.

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