Abstract
Keyhole to no hole hysterectomy - A retrospective analysis of NDVH and TLH in a teaching hospital - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/2394-2754.2018.0020, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol Res
Highlights
Prior to medical advances in yester years VH was limited to uterine prolapse but in present techno-medical era the techniques and indications of vaginal hysterectomy have changed to give an excellent health care to women cosmetically at a reasonable cost with minimum invasion and maximum safety and satisfaction
NDVH was pioneered by Haene in 1934.1 Over the time many changes have occurred in the modes of hysterectomy but in the present scenario where patients desire to get scar less surgery at an affordable cost, vaginal route will prove its worth by being the most satisfying, cost effective and safe method of hysterectomy as compared to other routes both for the surgeon and the patient
Result and Discussion In this study we retrospectively analysed the data of randomly selected 120 patients who underwent NDVH and TLH out of total 568 hysterectomy performed during the study period and found AH(49.87%) on top of the list followed by VH(21.15%) and NDVH (16.55%) lastly TLH (12.43%) In 27 cases of NDVH salpingo-opharectomy was done
Summary
Prior to medical advances in yester years VH was limited to uterine prolapse but in present techno-medical era the techniques and indications of vaginal hysterectomy have changed to give an excellent health care to women cosmetically at a reasonable cost with minimum invasion and maximum safety and satisfaction. Rate of conversion to AH was more with TLH due to haemorrhage in 3 and bladder injury in one of our cases, in comparison two cases in NDVH due to rectal and bladder injury Blood loss in both the surgery was comparable as mean post op Hb in both group were 9.5 & 9.8 with no significant p value. There is need for expanding the indications of performing hysterectomy via vaginal non laparoscopic method, instead of confining it to the conventional uterine descent.[2] TLH the minimal invasive abdominal route has its own place, but should be taken as mode of surgery only in selected cases as it is rightly observed by Neelam N. et al in her study that TLH is not cost effective as it requires costly set up, delicate expensive instruments, trained and expert team, major intraoperative complications long operation time more cost, not within the reach of majority of patients in Indian scenario. It requires less operative time, less intra operative bleeding, less post-operative morbidity, with regular infrastructural setup as observed by Shibara Chattopadhyay et al in his study.[3,4]
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