Aim: Hysterectomy is one of the most common surgeries being performed in perimenopausal women. It can be done either vaginally, abdominally or laparoscopically. The laparoscopic surgery is now on rising trend since it is associated with less peroperative complications, less postoperative pain, has better wound healing and early recovery and returns to normal activities. Hence, this study is being conducted to compare abdominal and laparoscopic hysterectomy.
Materials and methods: A retrospective observational study is conducted at the tertiary hospital. Total 135 women underwent surgery, of which 100 had an abdominal hysterectomy (TAH) while 35 had a laparoscopic hysterectomy (TLH). In mobile uterus of size < 12 weeks, TLH was done. The comparison was done between two groups as per and postoperative complications.
Results: The mean age, parity, and BMI was comparable in two groups. Duration of hospital stay was significantly less in women who underwent TLH. Peroperative complications as bowel and bladder injury were found in 4 cases and all of them occurred during TAH. Wound sepsis was also seen during TAH only. However, postoperative blood transfusion was given in more number of women who underwent TLH than in TAH, although the difference was statistically insignificant.
Conclusion: Laparoscopic hysterectomy is preferred over open procedure as it is associated with less per-operative complications, shorter hospital stay, and wound complications.
Laparoscopic surgery is more beneficial to the patient than abdominal hysterectomy. However, the decision regarding the mode of surgery shall be based on patient consent and surgical expertise.
Mattingly RF, Thompson JD. Leiomyomata uteri and abdominal hysterectomy for benign disease. In: JD Thompson., editor. In Te Linde's Operative Gynecology, 6th ed. Edited by RF Mattingly. Philadelphia: JB Lipincott; 1985. pp. 230-242.
Reich H. 13 New techniques in advanced laparoscopic surgery. Baillière's Clinical Obstetrics and Gynaecology. 1989 Sep 1;3(3):655-681.
Phipps JH, John M, Nayak S. Comparison of laparoscopically assisted vaginal hysterectomy and bilateral salpingoophorectomy with conventional abdominal hysterectomy and bilateral salpingo-ophorectomy. BJOG: An International Journal of Obstetrics & Gynaecology. 1993 Jul;100(7):698-700.
Balcý O. Comparison of total laparoscopic hysterectomy and abdominal hysterectomy. Turk J Obstet Gynecol. 2014 Dec;11(4):224-227.
Loh FH, Koa RC. Laparoscopic hysterectomy versus abdominal hysterectomy: a controlled study of clinical and functional outcomes. Singapore Med J. 2002 Aug;43(8):403-407.
Frigerio L, Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi M. Laparoscopic assisted hysterectomy versus abdominal hysterectomy in endometrial cancer. Int J Gynecol Obstet.2006;93(3):209-213.
Shridhar M, Chillamherla S. Comparison of open hysterectomy and total laparoscopic hysterectomy: a study in a teaching hospital. International surgery journal. 2016 Feb;3(1):296-300.
Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M et al. Evaluate hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess. 2004 Jun; 8(26):1-154.
Lumsden MA, Twaddle S, Hawthorn R, Traynor I, Gilmore D, Davis J et al. A randomised comparison and economic evaluation of laparoscopic assisted vagnal hysterectomy and abdominal hysterectomy. British journal of obstetrics and gynaecology 2000;107:1386-1391.
Mäkinen J, Johansson J, Tomas C, Tomas E, Heinonen PK, Laatikainen T, Kauko M, Heikkinen AM, Sjöberg J. Morbidity of 10 110 hysterectomies by type of approach. Human Reproduction. 2001 Jul 1;16(7):1473-1478.
Kanmani M, Govindarajan M, Selvaraj V. Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study. Int J Reprod Contracept Obstet Gynecol 2018;7:1019-1023.
Patel N, Delvadia D, Musselman B. Ribbon Coring Technique: An Alternative Approach to Morcellation. Journal of Minimally Invasive Gynecology. 2014 Nov 1;21(6):S221.
Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2006 Apr 19;(2):C D003677.CZ