Outcomes Of Total Laparoscopic Hysterectomy Research Articles

A Comparison between Total Abdominal Hysterectomy versus Total Laparoscopic Hysterectomy.

To compare the operative and postoperative outcomes of total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH). In this retrospective comparative study, we reviewed all hysterectomies performed in the Al-Karak Governmental Hospital in Al-Karak, Jordan, from September 2018 to July 2022. We enrolled 129 patients who underwent hysterectomy. The patients were divided into the TLH (n = 39) and TAH (n = 90) groups. Patient data were accessed through hospital records and analyzed using SPSS 25.0. The most common indication for TLH was uterine fibroid, and that for TAH was abnormal uterine bleeding, although the specimen weights were comparable. There was no significant between-group difference in the patient's demographics. Although the TLH group had longer operative time, the hospital stay was shorter and there were no reported cases of wound infection. The estimated blood loss was significantly lower in the TLH group than in the TAH group, but there was no difference between the two groups in terms of blood transfusion requirement and postoperative hemoglobin level. TLH and TAH had comparable overall outcomes in the Al-Karak Governmental Hospital. However, TLH was superior to TAH in terms of blood loss, and patients with TLH recovered faster without postoperative wound infection.

Clinical analysis of acute postoperative pain after total laparoscopic hysterectomy for adenomyosis and uterine fibroids – a prospective observational study

Objective To investigate the outcome of total laparoscopic hysterectomy (TLH) and postoperative pain characteristics and compare the pain severity after TLH for adenomyosis or uterine fibroids. Methods This prospective observational study collected 101 patients received TLH for adenomyosis (AD group) including 41 patients were injected goserelin (3.6 mg) 28 days before TLH, while other adenomyosis patients received TLH without preoperative treatment, and 113 patients received TLH for uterine fibroids (UF group). Pain scores were evaluated at different time sites from operation day to postoperative 72 h using the numeric rating scale. Clinical data were collected from clinical record. Results Operative time and anaesthetic time were longer in the AD group than those in the UF group (66.88 ± 8.65 vs. 64.46 ± 7.21, p = 0.04; 83.95 ± 10.05 vs. 79.77 ± 6.88, p < 0.01), severe endometriosis was quite more common in AD group (23.76% vs. 2.65%, p < 0.01). Postoperative usage of Flurbiprofen in AD group were more than that of UF group (15.48 ± 38.00 vs. 4.79 ± 18.16, p = 0.02). Total pains and abdominal visceral pains of AD group were more severe compared with UF group in motion and rest pattern at several time sites, while incision pain and shoulder pain were similar. The total postoperative pains after goserelin preoperative treatment in AD group were less than that without goserelin preoperative treatment (p < 0.05). The levels of serum NPY, PGE2 and NGF after laparoscopic hysterectomy of adenomyosis reduced with GnRH agonist pretreatment. Conclusions Acute postoperative pain for adenomyosis and uterine fibroids showed considerably different severity, postoperative total pain and abdominal visceral pains of TLH for adenomyosis were more severe compared with uterine fibroids. While patients received goserelin before laparoscopic hysterectomy of adenomyosis suffered from less severity of postoperative total pain than that without goserelin preoperative treatment.

Comparison of Outcomes of Total Laparoscopic Hysterectomy versus Total Abdominal Hysterectomy

Background: Hysterectomy is the most common gynecological procedure performed worldwide. Recently, total laparoscopic hysterectomy (TLH) has been presented as an effective substitute for total abdominal hysterectomy (TAH). Objective: To compare operative and postoperative outcomes of TLH with TAH. Methods: This Quasi-experimental study was conducted at the department of Obstetrics and Gynecology of Hameed Latif hospital, Pakistan from December 2018 to June 2019. A total of 116 patients (58 in each group) undergoing hysterectomy, meeting the selection criteria were included in the study. Intraoperative and postoperative evaluations included intraoperative blood loss estimation and post-operative hospital stay. All data were recorded in a predesigned study proforma. Data were analyzed through SPSS version 23. Results: The mean age of patients in TLH and TAH was 47.28±4.62 years and 47.22±4.72 years respectively. The mean blood loss in the TLH group was 216.28±149.85 ml and in TAH group was 371.38±147.16 ml with statistically significant lower mean blood loss in TLH group (p-value &lt; 0.001). Mean duration of hospital stay in the TLH group was 2.28±1.23 days and in the TAH group versus 3.86±1.30 days in TAH group (p-value &lt; 0.001). Conclusion: Mean blood loss and hospital stay were statistically lower in TLH when compared with TAH. Adequate training of the staff can ensure adoption of laparoscopic procedure due to improved intraoperative and postoperative outcomes.

Outcome of total Laparoscopic Hysterectomy in adult females with Benign Uterine Pathology

Background: Laparoscopic hysterectomy literature showed varied results regarding outcome of laparoscopic hysterectomy. Moreover, there is no local evidence which could help us to determine the outcome of laparoscopic hysterectomy in females having uterine pathology. Methods: This descriptive case series was conducted in the Department of Obstetrics &amp; Gynecology, Imran Idrees Teaching Hospital Sialkot for a period of 11 months from 1-1-2022 to 30-11-2022. Total 175 patients fulfilling selection criteria were enrolled in the study from emergency. Then all females underwent laparoscopic hysterectomy under general anesthesia. During surgery, operative time was noted. During surgery, bladder injury was noted if occurred (as per operational definition). Patients were shifted in post-surgical wards and were discharged from there after recovery. Results: In this study the main outcome variables were operative time, hospital stay and bladder damage. Mean operative time and hospital stay for patients who underwent laparoscopic hysterectomy was 170.93±49.18 minutes and 2.63±0.60 days. None of the patients had bladder damage. Practical implication: Laparoscopic hysterectomy is a safe, effective, and reproducible technique that can be adopted after completing a period of training required to standardize the technique. It has been associated with lesser blood loss, shorter stay in hospital, quick return to normal activity, and fewer surgical site infections when compared with abdominal hysterectomy. This approach must be established in our real, day-to-day clinical practice. Conclusion: Laparoscopic hysterectomy is an effective procedure for benign uterine pathology in terms of minimal complication rate (bladder injury), shorter hospital stay and an average mean operative time. Hence showing very promising results and a better outcome for the patients Keywords: Laparoscopic Hysterectomy, Benign Uterine Pathology, Operative time, Hospital Stay

Impact of Uterine Size on Outcomes of Total Laparoscopic Hysterectomy for Uterine Leiomyomas

Background: Given that total laparoscopic hysterectomy (TLH) is less invasive than open surgery, its popularity has increased in Japan. The aim of the present study was to determine the most appropriate uterine size for the safe completion of TLH for the treatment of uterine leiomyomas. Methods: This retrospective study included 505 patients who underwent TLH for uterine leiomyomas. Patients were divided into three groups according to the weight of the excised uterus (&lt;500 g, n = 347; 500–1000 g, n = 125; &gt;1000 g, n = 33). TLH procedures were performed by a resident physician under the supervision of an attending physician. Clinical outcomes including blood loss and duration of surgery were collected from patients’ electronic medical records and compared according to uterine size. Magnetic resonance imaging (MRI) was performed prior to TLH for detection, localization, and measurement of the myoma. Results: Mean operation times were shortest (&lt;500 g: 163 min; 500–1000 g: 190 min; &gt;1000 g: 209 min) and the mean volume of blood lost was lowest (&lt;500 g: 116 mL; 500–1000 g: 208 mL; &gt;1000 g: 402 mL) in patients with a uterus weighing less than 500 g. There were no significant differences in operation time or bleeding between those with a uterine weight of 500–1000 g or &gt;1000 g. MRI revealed that myomas tended to be restricted within the sacral promontory in patients with uterine weights &lt;500 g, whereas those in the other two groups tended to extend beyond this region. Conclusions: TLH outcomes are best when the uterine weight is &lt;500 g. The use of MRI prior to TLH may provide insights into uterine size and/or mass and thus allow for improved surgical planning.

Recurrence and survival after laparoscopy versus laparotomy without lymphadenectomy in early-stage endometrial cancer: Long-term outcomes of a randomised trial

BackgroundLaparoscopic hysterectomy is accepted worldwide as the standard treatment option for early-stage endometrial cancer. However, there are limited data on long-term survival, particularly when no lymphadenectomy is performed. We compared the survival outcomes of total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH), both without lymphadenectomy, for early-stage endometrial cancer up to 5 years postoperatively. MethodsFollow-up of a multi-centre, randomised controlled trial comparing TLH and TAH, without routine lymphadenectomy, for women with stage I endometrial cancer. Enrolment was between 2007 and 2009 by 2:1 randomisation to TLH or TAH. Outcomes were disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS), and primary site of recurrence. Multivariable Cox regression analyses were adjusted for age, stage, grade, and radiotherapy with adjusted hazard ratios (aHR) and 95% confidence intervals (95%CI) reported. To test for significance, non-inferiority margins were defined. ResultsIn total, 279 women underwent a surgical procedure, of whom 263 (94%) had follow-up data. For the TLH (n = 175) and TAH (n = 88) groups, DFS (90.3% vs 84.1%; aHR[recurrence], 0.69; 95%CI, 0.31–1.52), OS (89.2% vs 82.8%; aHR[death], 0.60; 95%CI, 0.30–1.19), and DSS (95.0% vs 89.8%; aHR[death], 0.62; 95%CI, 0.23–1.70) were reported at 5 years. At a 10% significance level, and with a non-inferiority margin of 0.20, the null hypothesis of inferiority was rejected for all three outcomes. There were no port-site or wound metastases, and local recurrence rates were comparable. ConclusionDisease recurrence and 5-year survival rates were comparable between the TLH and TAH groups and comparable to studies with lymphadenectomy, supporting the widespread use of TLH without lymphadenectomy as the primary treatment for early-stage, low-grade endometrial cancer.

Surgical Approach for Enlarged Uteri: Further Tailoring of vNOTES Hysterectomy

This article refers to:Comparison of Surgical Outcomes of Total Laparoscopic Hysterectomy and vNOTES Hysterectomy for Undescended-Enlarged Uteri

Comparison of Surgical Outcomes of Total Laparoscopic Hysterectomy and vNOTES Hysterectomy for Undescended-Enlarged Uteri

Aim This study aimed to compare the surgical outcomes of laparoscopic hysterectomy (LH) and vaginally assisted natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy procedures in women with undescended-enlarged uteri. Materials and methods This cross-sectional study was conducted with 78 women who underwent LH (48 patients) or vNOTES hysterectomy (30 patients) for benign gynecological pathologies. The dimension of the uterus, operation time, intraoperative blood loss, the presence of peri-, postoperative complications, conversion to laparotomy, pre-, postoperative hemoglobin (Hb), and hematocrit (Hct) levels, postoperative hospital stay, total dose of postoperative analgesics, VAS scores at the postoperative 6th and 24th hours, and the final pathology reports were recorded. Results There was no significant difference between LH and vNOTES hysterectomy groups regarding age (47 vs. 47.5 years, p = 0.92), parity (2 vs. 2, p = 0.74), and BMI (30.8 vs. 28.2 kg/m2, p = 0.31). The patients in the vNOTES hysterectomy group had significantly shorter durations of surgery (45 vs. 160 min) and hospitalization (48 vs. 72 h) than the LH group (p < 0.001, p < 0.001, respectively). The 24th hour VAS score was lower (VAS score 2 vs. 3, p = 0.003) in favor of the vNOTES hysterectomy group. In matched group analysis, the 24th hour VAS score (2 vs. 3, p = 0.008), operation time (45 vs. 157, p < 0.001), and hospitalization (48 vs. 72, p < 0.001) were lower in the vNOTES hysterectomy group than the LH group. Conclusion vNOTES hysterectomy provides favorable outcomes compared to conventional LH considering the shorter operation time, hospitalization, and lower 24th h VAS score.

Previous Abdominal Surgery and Obesity Do Not Affect Outcomes of Total Laparoscopic Hysterectomy Adversely

Objective: The aim of this research was to assess the effects of previous abdominal surgery and obesity on the outcomes of total laparoscopic hysterectomy (TLH). Materials and Methods: In this retr...

A Comparative Study of the Influence of Body Mass Index on Clinical Outcomes of Total Laparoscopic Hysterectomy in Birat Medical College Teaching Hospital, Morang, Nepal

Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult.&#x0D; Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy.&#x0D; Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each&#x0D; Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups.&#x0D; Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy.

The Comparison of Surgical Outcomes following Laparoscopic Hysterectomy and vNOTES Hysterectomy in Obese Patients

Aim This study aimed to compare the surgical outcomes of total laparoscopic hysterectomy (TLH) and vaginally assisted natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy procedures in obese patients. Materials and methods This cross-sectional study was conducted with 83 obese women (BMI > 30 kg/m2) who underwent TLH (35 patients) or vNOTES hysterectomy (48 patients) for benign gynecological indications. The duration of surgery, intra/postoperative complications, intra- and postoperative hemoglobin (Hb) and hematocrit (Hct) levels, hospital stay, Visual analogue scale (VAS) scores at the postoperative 6th and 24th hours of the patients were compared. Results There was no significant difference between TLH and vNOTES groups regarding age (49 vs. 52 years, p = 0.35), parity (2 vs. 3, p = 0.17), and uterine weight (290 vs. 230 g., p = 0.13) The median BMI was 31.6 kg/m2 (30–42.2 kg/m2) in the TLH group and 31.9 kg/m2 (30–54.6 kg/m2) in the vNOTES group (p = 0.31). The vNOTES hysterectomy group had significantly shorter durations of surgery (67.5 vs. 136 min) and postoperative hospitalization than the TLH group (p < 0.05 for all comparisons). Besides, the 6th-hour (6 vs. 7, p = 0.02) and 24th-hour (4 vs. 3, p < 0.001) VAS scores were significantly lower in the vNOTES hysterectomy group. The propensity-matched group analysis showed significantly lower 6th-hour and 24th-hour VAS scores and shorter duration of surgery (80 vs. 135 min, p < 0.001) in the vNOTES hysterectomy group than the TLH group. Conclusion vNOTES is a feasible technique in obese women who require a hysterectomy and provides favorable outcomes considering the shorter duration of surgery and postoperative hospitalization and lower pain scores.

Surgical outcomes of conventional laparoscopic and robotic-assisted hysterectomy.

The aim of the present study was to compare surgical outcomes of total laparoscopic hysterectomy with those of the robotic approach using the da Vinci Xi system. Patients who underwent hysterectomy with da Vinci Xi for early endometrial cancer or benign indications from 2018 to 2019 were selected. The control group consisted of patients who underwent conventional laparoscopy. A total of 300 patients were included in the study. The mean duration of surgery differed significantly (p=0.025) between those who underwent laparoscopy (125.01±76.168) and robotic-assisted surgery (142.96±82.657 min). Blood loss, median hospital stay, intraoperative and postoperative complications were similar in both groups. No statistical difference was observed in the subgroups with a body mass index of more than 30 kg/m2 or more than 40 kg/m2 concerning the duration of surgery or the surgical outcome. The da Vinci Xi did not improve surgical outcomes in patients who underwent hysterectomy by trained laparoscopists and takes more time than conventional laparoscopy when performed in patients of normal weight.

Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases.

IntroductionIn this study, we reported a single surgeon experience of total laparoscopic hysterectomy (TLH) in terms of intraoperative and early postoperative outcomes and complications. In addition, we compared our results with published literature for a reevaluation of complications and outcomes.Material and methodsThis present prospective study was conducted on 50 patients who underwent TLH due to benign causes. Patients diagnosed with abnormal uterine bleeding (AUB), uterine fibroids, and post-menopausal bleeding (PMB) were included in this analysis. Patients were discharged after 24 hours of surgery if there were considered fit for discharge. The patients' age, co-morbidities, size of the uterus, additional procedure along with TLH, and postoperative complications were collected and analyzed. The follow-up period was three months, done on the tenth day after surgery, the thirtieth day, and then at three months.ResultsThe mean age of our patients was 46.42±5.01 years. The major indication of hysterectomy was fibroids diagnosed in 27 (54.0%) patients and AUB in 18 (36.0%) patients. Out of 50, 10 (20.0%) patients had a previous cesarean section, and 4 (8.0%) had a bilateral tubal ligation (BTL). Mean surgery duration was 124.26±44.74 minutes. Mean hospital stay was 2.18±0.39 days. Total complications occurred in five (10.0%) patients, ureteric injury in one (2.0%) patient, port-site infections in 2 (4.0%), and vault infections in 2 (4.0%) patients.ConclusionTLH is a safe procedure and can be performed with minimal complications in patients with benign uterine etiology.

Outcome of total laparoscopic hysterectomy in women with previous caesarean section

Aims: To assess the surgical outcome of total laparoscopic hysterectomy performed in women with previous caesarean section.&#x0D; Methods: This is a cross sectional analytical study conducted at Birat Medical College, Teaching Hospital from 1 May 2019 to 28 February 2020. One hundred thirty patients undergoing total laparoscopic hysterectomy were categorized in two groups with and without previous caesarean section. The data were entered into Microsoft Excel and analyzed by using statistical package for social studies (SPSS 23.0).&#x0D; Results: The overall complication rate was 3.87% (5/130) with 4.61% (3/65) in previous cesarean section and 3.07% (2/65) without it. Urinary tract injury was the common injury. Mean operating time was slightly higher in previous cesarean section but was not statistically significant.&#x0D; Conclusions: Total laparoscopic hysterectomy can be performed in patients with previous caesarean section without any significant increase in intraoperative and immediate postoperative complications.&#x0D; Keywords: adhesion, caesarean section, hysterectomy, laparoscopic

80: Effect of surgical case order on perioperative outcomes of total laparoscopic hysterectomy for benign indications

To determine whether surgical case order affects complication rate (CR), estimated blood loss (EBL), and operating time (OT) at the time of total laparoscopic hysterectomy (TLH). This was a retrospective cohort study using single institution data that was collected using methods instituted by and submission to the National Surgical Quality Improvement Program Database (NSQIP). Women undergoing TLH for benign indications were included in this database. Procedures were stratified into either first cases, performed by a surgeon who had not performed any prior surgery on the day of that TLH; second cases were those preceded by a TLH performed by the same surgeon who was performing the second case. Cases which included concomitant procedures were included as long they were performed by the same surgeon who performed the TLH and the primary indications for surgery were related to uterine or adnexal pathology. Cases preceded by any operation other than a TLH were excluded. Pairwise analysis was performed between groups using the Wilcoxon rank-sum test or Fisher’s exact test where appropriate. Multivariable regression was used to identify predictors of CR, EBL > 100 mL, and operating time longer than 150 minutes. CR included perioperative and postoperative complications including urinary and intestinal tract injury, emergency room visits, readmissions, and reoperations within 30 days of and directly related to TLH. A total of 260 procedures were included, 130 in each group. Second order cases were more likely to include minority patients (67.9% vs 47.2%, p=0.007) and have a slightly lower starting hematocrit (38.6% vs 37.0%, p=0.009). EBL was higher in second order cases (50 mL vs 25 mL, p=0.03) and excision of endometriosis was performed more often in the first order cases (40.0% vs 27.7%, p=0.04). There were no differences in comorbidity rates, surgical indications, operating time, uterine weight or concomitant procedures. The CR was 19.6%, and did not differ between groups, p=0.92. After adjusting for confounders, second case order was only associated with an increased risk of EBL > 100 mL, aOR=2.57, 95% CI: 1.38-4.79; however, this did not result in higher transfusion rates in this group. Case order was not independently associated with higher CR or longer OT. Total laparoscopic hysterectomy performed as the second case and preceded by TLH are associated with higher EBL. However, this increase is not likely to be clinically significant as it is well below the limit of blood loss that necessitates transfusion. Case order was not independently associated with increases in operating time or complication rates.

Prognostic outcomes of total laparoscopic hysterectomy vs. total abdominal hysterectomy for early-stage endometrial carcinoma

Prognostic outcomes of total laparoscopic hysterectomy vs. total abdominal hysterectomy for early-stage endometrial carcinoma

Outcome of Total laparoscopic hysterectomy in Qena University Hospital

Outcome of Total laparoscopic hysterectomy in Qena University Hospital

Clinical Outcomes of Total Laparoscopic Hysterectomy (TLH): Seven Years’ Experience in a Public Hospital

Objective: The aim of the study was to explore the surgical outcomes of total laparoscopic hysterectomy.&#x0D; Materials and methods: This was a prospective analysis of total Laparoscopic Hysterectomy (TLH) done between January, 2012 to December, 2018 in Shaheed Suhrawardy Medical College and Hospital. Demographic data, clinical criteria, intra operative and postoperative outcome data were recorded. Data were collected in a predesigned Data collection sheet. Follow up records done during discharge from the hospital, one week and four weeks postoperatively.&#x0D; Results: Total 298, laparoscopic hysterectomy were performed during the period. Among them 96 % (n=286) for benign and 4 %( n=12) for malignant condition were included in the study population. Mean age of the patients was 45.4 ± 5.6 years, mean parity was 1.9 ± 0.64 and the mean body mass index was 27.48 ± 0.57. The most common benign disease was leiomyoma, 51.7 %. Among the study cases 21.8% (n=65) had history of at least one previous abdomino-pelvic surgery. Maximum size of uterus removed was 28 weeks and maximum patients, 48% (n=143) had uterine size of 10-14 weeks. The operating time was variable between 50 min to 180 min and in the course of time, the mean operating time dropped from 130 min to 60 min. The mean length of hospital stay was 2 days and the return to normal activities was within 2 weeks. Major complications observed among 3.7 % of cases among them 2(0.67%) bladder injury, 2(0.67%) vesico-vaginal fistula (VVF), 3(1.0%) ureterovaginal fistula (UVF) and 4(1.3%) peroperative hemorrhage requiring blood transfusion. Among the 7 cases of urological complications, one patient with VVF and one patient with UVF needed relaparotomy. Ultimately all cases were managed without any residual problem. Conversion to laparotomy was 0.3 % (n=1) of case.&#x0D; Conclusion: TLH offers the benefit of minimally invasive surgery to the patient and is a safe and acceptable alternative to standard hysterectomy for various gynaecological indications.&#x0D; Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 28-35

Outcome of total laparoscopic hysterectomy in relation to BMI – A prospective study

Introduction: Laparoscopy can be more complicated in the obese patient, but the complications tend to decrease over time with surgical experience. The aim of this study was to know the safety of total laparoscopic hysterectomy (TLH) for benign diseases in overweight and obese women when compared with women with lesser BMI. Materials and Methods: Total of 105 cases of TLH were analysed prospectively from October 2014 to August 2016. The patients were divided into 4 groups based on BMI; underweight, normal weight, overweight and obese and the demographic data and intra and post-operative parameters were recorded until one month post-operative follow up. The data obtained was analyzed using descriptive and inferential statistics. Result: Of 105 patients, 2(1.9%) were underweight, 14(13.3%) were normal weight, 20(19.0%) were overweight and 69 (65.7%) were obese. Majority were in the age group of 40 to 50 years. Fibroid was the main indication for hysterectomy. There were more number of women with blood loss of more than 100ml in overweight and obese group but the difference was not statistically significant. None of the women in all the groups suffered any major complication. The operation time was more in obese women when compared with the other groups but the difference was not statistically different. Also, when we compared the pain scores at 6 hours, 24 hours and at discharge, we found no difference between the groups. Conclusion: TLH is safe and effective in women of all BMI categories undergoing hysterectomy for benign diseases. Keywords: TLH, BMI, Operation time, Complications, Pain score, Opioid analgesia.

Models for predicting surgical outcomes of total laparoscopic hysterectomy

Models for predicting surgical outcomes of total laparoscopic hysterectomy