Total laparoscopic hysterectomy versus vaginal hysterectomy: A comparative study

Abstract

Background: Total laparoscopic hysterectomy (TLH) is now emerging as a safe procedure even in patients suitable for vaginal hysterectomy (VH) due to its advantages like better visualization, less post-operative pain and shorter hospital stay. The present study was carried out to compare the TLH and VH with respect to duration of surgery, intra and postoperative complications, hospital stay and post-operative analgesia requirement. Methods: Patients undergoing both the types of hysterectomy i.e. TLH and VH during January 2017 to December 2017 at KB Bhabha Hospital, Mumbai were included in the study. Patients with suspected genital malignancy and uterine prolapsed were excluded. Baseline characteristics, intra and post-operative parameters like duration of surgery, complications, post-operative analgesic dosage and hospital stay were recorded and compared between the two surgeries. Results: The mean time taken to perform TLH was significantly longer i.e. 100.21 minutes compared with VH, i.e. 80.16 minutes (p <0.0001). But the mean duration of hospital stay was shorter for the women undergoing TLH i.e. 3.2 days as opposed to 5.15 days in women undergoing VH (p<0.0001). The mean post-operative analgesia requirement was more in women undergoing VH (1.87) than those undergoing TLH (mean 1.01). There was no statistically significant difference observed between two groups with respect to rate of complications. Conclusions: Total laparoscopic hysterectomy, notwithstanding its learning curve, is as safe as vaginal hysterectomy.