World Journal of Laparoscopic Surgery

Register      Login

VOLUME 16 , ISSUE 1 ( January-April, 2023 ) > List of Articles

Original Article

Total Laparoscopic Hysterectomies at Tertiary Care Center: A Retrospective Analysis

Ankush Ajmera, Shyamkumar Sirsam, Sasireka Kuppusamy, Rajat Sharma

Keywords : Hysterectomy, Laparoscopy, Minimally invasive surgey, Retrospective

Citation Information : Ajmera A, Sirsam S, Kuppusamy S, Sharma R. Total Laparoscopic Hysterectomies at Tertiary Care Center: A Retrospective Analysis. World J Lap Surg 2023; 16 (1):11-14.

DOI: 10.5005/jp-journals-10033-1556

License: CC BY-NC 4.0

Published Online: 05-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: After cesarean section, hysterectomy is the second most common procedure performed in the OBGY department. In this study, we analyzed the safety and complications of total laparoscopic hysterectomy (TLH) at our tertiary care center. Total laparoscopic hysterectomy is the preferred procedure over the laparotomy because of higher feasibility and lower postoperative complications. Materials and methods: This is a retrospective cohort study conducted on 200 patients who underwent TLH due to various benign gynecological conditions from January 1, 2017 to July 31, 2022. The statistical analysis was done using EPIINFO software. Results: The mean age of the women undergoing TLH at our center was 42 years. About 52% of the women were having parity 2, 43% were having a uterine size between 6 and 12 weeks. The most common symptom and indication for TLH were heavy menstrual bleeding (75.5%) and AUB L (leiomyoma) is about 49%, respectively. The average blood loss in the study was 150 mL. The mean duration of surgery was 50 minutes. The mean duration of hospital stay was 3 days. And 4% of the patients had intraoperative complications, 9% had postoperative complications which were identified and managed successfully. Conclusion: Laparoscopic gynecological surgeries are safe procedures in terms of feasibility in obese patients, minimal blood loss, and postoperative complications in patients with benign uterine etiology. Greater technical challenges and advanced equipment with long learning curve make it difficult for all surgeons to practice it.

  1. Sutton C. Past, present, and future of hysterectomy. J Minim Invasive Gynecol 2010;17(4):421–435. DOI: 10.1016/j.jmig.2010.03.005.
  2. Lee Pl, Lee YT, Lee SH, et al. Advantages of total laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc 1996 Aug;3(4, Supplement):S24–25. DOI: 10.1016/s1074-3804(96)80216-7.
  3. Einarsson JI, Matteson KA, Schulkin J, et al. Minimally invasive hysterectomies—a survey on attitudes and barriers among practicing gynecologists. J Minim Invasive Gynecol 2010;17(2):167–175. DOI: 10.1016/j.jmig.2009.12.017.
  4. Agarwal P, Bindal N, Yadav R. Risks and benefits of total laparoscopic hysterectomy and the effect of learning curve on them. J Obstet Gynaecol India 2016; 66(5):379–384. DOI: 10.1007/s13224-015-0706-9.
  5. Marwah V, Dutta S, Kedia S, et al. Total laparoscopic hysterectomy (TLH) with endosuturing compared with conventional technique using energy sources. Facts Views Vis ObGyn 13(2):149–158. DOI: 10.52054/FVVO.13.2.018.
  6. Ballantyne GH. The pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc Percutan Tech 2002;12(1):1–5. DOI: 10.1097/00129689-200202000-00001.
  7. Panda S, Behera AK, Jayalakshmi M, et al. Choosing the route of hysterectomy. J Obstet Gynaecol India 2015;65(4):251–254. DOI: 10.1007/s13224-014-0562-z.
  8. Kumar S, Vijan T. Hysterectomy: rates and routes controversies. MGM J Med Sci 2021;8(4):321. DOI: 10.4103/mgmj.mgmj_92_21.
  9. Ray A, Pant L, Magon N. Deciding the route for hysterectomy: Indian triage system. J Obstet Gynaecol India 2015;65(1): 39–44. DOI: 10.1007/s13224-014-0578-4.
  10. Garry R, Fountain J, Mason S, et al. The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 2004;328(7432):129. DOI: 10.1136/bmj.37984.623889.F6.
  11. Mani K, Govindarajan M, Selvaraj V. Comparison of total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy – a 2-year retrospective study. Int J Reprod Contracept Obstet Gynecol 2017;6(3):966–969. DOI: 10.18203/2320-1770.ijrcog20170566.
  12. Shin JW, Lee HH, Lee SP, et al. Total laparoscopic hysterectomy and laparoscopy-assisted vaginal hysterectomy. JSLS 2011; 15(2):218–221. DOI: 10.4293/108680811X13071180406394.
  13. Bastidas-Guarín C, Zambrano-Moncayo CP, López-Isanoa JD, et al. Seguridad de la histerectomía total por laparoscopia entre el 2007 y 2017 en un hospital de alta complejidad, Pereira, Colombia. estudio de cohorte. Rev Colomb Obstet Ginecol 2020;71(3):257–264. DOI:
  14. Dojki SS, Bano A. Outcome of total laparoscopic hysterectomy. J Coll Physicians Surg--Pak JCPSP 2018;28(6):427–430. DOI: 10.29271/jcpsp.2018.06.427.
  15. Suisted P, Chittenden B. Perioperative outcomes of total laparoscopic hysterectomy at a regional hospital in New Zealand. Aust N Z J Obstet Gynaecol 2017;57(1):81–86. DOI: 10.1111/ajo.12570.
  16. Chilkund JN, Gadgil JJ. Gynaecologic laparoscopic surgery using spinal anaesthesia – a retrospective observational study. J Evol Med Dent Sci 2020;9(12):924–927. DOI: 10.14260/jemds/2020/199.
  17. Bettaiah R, Reddy CAR. Laparoscopic hysterectomies: Our 10 years experience in a single laparoscopic center. J Obstet Gynaecol India 2016;66(4):274–281. DOI: 10.1007/s13224-014-0665-6.
  18. Rentiya FM, Desai AN. Total laparoscopic hysterectomy: an experience at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2019;8(11):4341–4345. DOI: 10.18203/2320-1770.ijrcog20194854.
  19. Puntambekar S, Shetty TS, Goel A, et al. Single-centre experience of doing safe total laparoscopic hysterectomy: retrospective analysis of 1200 cases. J Obstet Gynaecol India 2020;70(5):376–383. DOI: 10.1007/s13224-020-01333-5.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.