Page 11 - Journal of Laparoscopic Surgery
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Rising Trend of Laparoscopic Hysterectomy Over Abdominal Hysterectomy: A Comparative Study
In five women who underwent TLH, postoperative REFERENCES
blood transfusion and prolonged catheterisation was 1. Mattingly RF, Thompson JD. Leiomyomata uteri and abdomi-
done. But in all of these cases, size of uterus was > 12 nal hysterectomy for benign disease. In: JD Thompson.,
weeks and fibroid of size 5 to 10 cm was present, because editor. In Te Linde’s Operative Gynecology, 6th ed. Edited by
of which peroperative blood loss was little more and RF Mattingly. Philadelphia: JB Lipincott; 1985. pp. 230-242.
hence, postoperative transfusion was given and catheter 2. Reich H. 13 New techniques in advanced laparoscopic
was kept for longer period for prophylactic purpose. In surgery. Baillière’s Clinical Obstetrics and Gynaecology. 1989
Sep 1;3(3):655-681.
these cases of large fibroid uterus, first Myomectomy 3. Phipps JH, John M, Nayak S. Comparison of laparoscopi-
was done and then we proceeded with hysterectomy. cally assisted vaginal hysterectomy and bilateral salpingo-
Both uterus and fibroid were removed by Ribbon Coring ophorectomy with conventional abdominal hysterectomy
12
technique vaginally. However, none of the patient had and bilateral salpingo-ophorectomy. BJOG: An International
bladder or ureteric injury, and catheter was kept for Journal of Obstetrics & Gynaecology. 1993 Jul;100(7):698-700.
little longer time for prophylactic purpose, especially in 4. Balcı O. Comparison of total laparoscopic hysterectomy
women with adherent bladder or previous surgery. and abdominal hysterectomy. Turk J Obstet Gynecol. 2014
Dec;11(4):224-227.
In a Cochrane database systemic review Johnson 5. Loh FH, Koa RC. Laparoscopic hysterectomy versus abdomi-
13
et al., surgical approach to hysterectomy was given for nal hysterectomy: a controlled study of clinical and functional
benign diseases. When TLH was compared to TAH, it outcomes. Singapore Med J. 2002 Aug;43(8):403-407.
was found that TLH is associated with more benefits in 6. Frigerio L, Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi
term of lower intraoperative blood loss, shorter duration M. Laparoscopic assisted hysterectomy versus abdomi-
of hospital stay, speedier return to normal activities, fewer nal hysterectomy in endometrial cancer. Int J Gynecol
Obstet.2006;93(3):209-213.
wound or abdominal wall infections, fewer unspecified 7. Shridhar M, Chillamherla S. Comparison of open hyster-
infections or febrile episodes, but more urinary tract ectomy and total laparoscopic hysterectomy: a study in
(bladder or ureter) injuries. Hence, it was concluded a teaching hospital. International surgery journal. 2016
that vaginal hysterectomy (VH) should be performed in Feb;3(1):296-300.
preference to abdominal hysterectomy where possible 8. Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M
and in cases where VH is not possible, laparoscopic hys- et al. Evaluate hysterectomy trial: a multicentre randomised
trial comparing abdominal, vaginal and laparoscopic
terectomy may avoid the need for abdominal surgery. methods of hysterectomy. Health Technol Assess. 2004 Jun;
8
In another meta analysis by Garry et al., it was 8(26):1-154.
reported that although laparoscopic surgery has been 9. Lumsden MA, Twaddle S, Hawthorn R, Traynor I, Gilmore
associated with major complications, but still it leads D, Davis J et al. A randomised comparison and economic
to less post operative pain and quick recovery. Hence, evaluation of laparoscopic assisted vagnal hysterectomy and
surgeon should decide the mode of surgery after weigh- abdominal hysterectomy. British journal of obstetrics and
gynaecology 2000;107:1386-1391.
ing risk and benefits associated with surgery. 10. Mäkinen J, Johansson J, Tomas C, Tomas E, Heinonen PK,
Hence, it can be observed that laparoscopic surgeries Laatikainen T, Kauko M, Heikkinen AM, Sjöberg J. Morbid-
are beneficial but the pros and cons should be equally ity of 10 110 hysterectomies by type of approach. Human
balanced before deciding the mode of surgery. Reproduction. 2001 Jul 1;16(7):1473-1478.
11. Kanmani M, Govindarajan M, Selvaraj V. Comparative study
CONCLUSION of surgical results between total abdominal hysterectomy
and total laparoscopic hysterectomy in a tertiary hospital:
Laparoscopic hysterectomy is the upcoming procedure a 2 year retrospective study. Int J Reprod Contracept Obstet
which is associated with less post operative complica- Gynecol 2018;7:1019-1023.
tions, shorter hospital stay and wound complications as 12. Patel N, Delvadia D, Musselman B. Ribbon Coring Technique:
compared to abdominal hysterectomy. Hence, it can be An Alternative Approach to Morcellation. Journal of Mini-
mally Invasive Gynecology. 2014 Nov 1;21(6):S221.
the preferred over open procedure especially in cases 13. Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry
with previous surgery and obesity. However, decision R. Surgical approach to hysterectomy for benign gynaecologi-
shall be taken with patient consent and better surgical cal disease. Cochrane Database Syst Rev. 2006 Apr 19;(2):C
expertise. D003677.CZ
World Journal of Laparoscopic Surgery, May-August 2018;11(2):59-63 63