Abstract
ObjectiveTo calculate the conversion rate and describe indications, type of surgery, and complications of laparoscopic hysterectomies in a district hospital, as well as to analyse surgical time and uterine weight. MethodsA descriptive and retrospective study was carried using the database of the Surgical Record of Gynaecology (Canadian Task Force classification III). It was conducted in the Gynaecology and Obstetrics Department of Valdeorras District Hospital (Orense, Spain).The study included 78 women scheduled for laparoscopic hysterectomy from May 2011 to February 2018. A description is presented of the demographic characteristics, symptoms, type of surgery, and previous medical treatments. A total of 62 total and 15 subtotal hysterectomies, were performed, as well as one Manchester surgery. A calculation was made of the rate of conversion, morcellation percentage, operating time, complications (classified according to the Clavien-Dindo scale and the Comprehensive Complication Index), and pathology results. ResultsThe conversion rate was 5.13%, and the morcellation percentage was 35.90%. A theoretical cut-off was calculated of a uterus weight of 190 grammes or more for being morcellated among total hysterectomies. There were no transfusions. There were longer operating times with junior surgeons, but no difference in surgical complications compared to senior surgeons. Complications according to the Clavien-Dindo scale: 10 patients grade I, 10 grade II, one grade IIIa, and 4 grade IIIb. Using the CCI, 20 patients attained a low score (<30 points), and 4 patients scored 31-40 points. A history of caesarean section was associated with a higher risk of bladder injury. Mean days to discharge was 2.48 days.There were no malignant samples among the morcellated uteruses. ConclusionsLaparoscopic hysterectomy is a technique that can be performed in a district hospital and in most cases with a minimum conversion rate and few complications.
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