A comparative study between Total Laparoscopic Hysterectomy (TLH) and conventional Total Abdominal Hysterectomy (TAH) in non-neoplastic uterine diseases

Abstract

Introduction:In the past decade, laparoscopic route of surgery has been on an increase especially for non-neoplastic uterine diseases. The present study aims to study and compare between Total Laparoscopic Hysterectomy (TLH) and conventional TAH (Total Abdominal Hysterectomy) in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Materials and methods: In this randomized prospective comparative study, 100 consecutive patients of hysterectomy (50 each of total TAH and TLH) at a tertiary care center in western India, were recruited. The present study aims to study and compare between TLH and conventional TAH (Total Abdominal Hysterectomy), in non-neoplastic uterine diseases, in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Results: We observed that average blood loss, postoperative pain and analgesic requirement and mean length of hospital stay in TLH was lesser than TAH group (p< 0.001). An average time taken for TLH as well as patient satisfaction level was more (p< 0.001) than that in TAH group. Intraoperative complications were comparable and not significantly different among the two procedures. Mobilization after the procedure was quicker in laparoscopic hysterectomy. Mobilization of patients during postoperative period was significantly earlier (p< 0.0001) in TLH group (12.2 hours) while in TAH (22.3 hours. Patient satisfaction level was 90% in patients in TLH group while only 60% for patients in TAH group. Conclusion: TLH is a safe and effective method of doing hysterectomy and it is a good alternative of conventional abdominal hysterectomy, especially after good training to standardized the procedure, proper case selection, day to day practice of the technique and application of sound surgical principles.