Page 7 - Journal of Laparoscopic Surgery

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10.5005/jp-journals-10033-1336
Rising Trend of Laparoscopic Hysterectomy Over Abdominal Hysterectomy: A Comparative Study
ORIGINAL RESEARCH

Rising Trend of Laparoscopic Hysterectomy Over

Abdominal Hysterectomy: A Comparative Study

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1 Nidhi Jain, Jyotsna Kamra, Alka Chabbra
ABSTRACT INTRODUCTION
Aim: Hysterectomy is one of the most common surgeries being Hysterectomy is one of the most common surgeries being
performed in perimenopausal women. It can be done either performed in women of perimenopausal age group. In
vaginally, abdominally or laparoscopically. The laparoscopic
surgery is now on rising trend since it is associated with less earlier days, it is done either vaginally or abdominally.
peroperative complications, less postoperative pain, has The vaginal route is the most preferred method as it is
better wound healing and early recovery and returns to normal associated with lesser per and postoperative complications
activities. Hence, this study is being conducted to compare with early recovery and lower morbidities. However, in cases
abdominal and laparoscopic hysterectomy.
where uterus size is large, removal of adnexa is required, or
Materials and methods: A retrospective observational study is vaginal access is narrow, the abdominal route is preferred.
conducted at the tertiary hospital. Total 135 women underwent
surgery, of which 100 had an abdominal hysterectomy (TAH) Abdominal hysterectomy is performed either by
while 35 had a laparoscopic hysterectomy (TLH). In mobile open technique (TAH) or laparoscopically (TLH/LAVH).
uterus of size < 12 weeks, TLH was done. The comparison Although TAH is a fast procedure with more cost effectivity,
was done between two groups as per and postoperative com- it is associated with more abdominal trauma, requires pro-
plications.
longed hospital stay and has a slower recovery rate. So, now
Results: The mean age, parity, and BMI was comparable in two a day, laparoscopic surgeries are on the inclining trends as
groups. Duration of hospital stay was significantly less in women it leads to less postoperative pain, has faster recovery, better
who underwent TLH. Peroperative complications as bowel and
bladder injury were found in 4 cases and all of them occurred wound healing and early return to normal activities.
during TAH. Wound sepsis was also seen during TAH only. Hence, this study is being conducted to compare per-
However, postoperative blood transfusion was given in more operative and postoperative complications of abdominal
number of women who underwent TLH than in TAH, although and laparoscopic hysterectomy.
the difference was statistically insignificant.
Conclusion: Laparoscopic hysterectomy is preferred over
open procedure as it is associated with less per-operative MATERIALS AND METHODS
complications, shorter hospital stay, and wound complica- A retrospective observational study was conducted in the
tions.
Department of Obstetrics and Gynaecology at a tertiary
Laparoscopic surgery is more beneficial to the patient than hospital for seven months (February 2018 to August 2018),
abdominal hysterectomy. However, the decision regarding the after clearance from the Institutional Ethical Committee.
mode of surgery shall be based on patient consent and surgical
expertise. A total of 135 women who underwent a hysterectomy
during this period were included in the study. Out of
Keywords: Abdominal, Hysterectomy, Laparoscopy.
these 135 women, 100 women (74.1%) had a TAH while
How to cite this article: Jain N, Kamra J, Chabbra A. Rising 35 (25.9%) underwent a laparoscopic hysterectomy. Of
Trend of Laparoscopic Hysterectomy Over Abdominal Hyster-
ectomy: A Comparative Study. World J Lap Surg 2018;11(2): these 35 women, 31 (88.6%) women had a TLH and in
59-63. rest 4 women (11.4%), LAVH was done.
Most of these patients presented to the outpatient
Source of support: Nil
department of our institute with a chief complaint of
Conflict of interest: None abnormal menstrual cycles. Few of them, presented with
abdominal pain or lump in the abdomen. After complete
history and examination, ultrasound pelvis was done. All
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1 Assistant Professor, Associate Professor, HOD peroperative investigations were done, and the patient
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1-3 Department of Obstetrics and Gynaecology, Maharaja was taken up for surgery with informed consent.
Agarsein Medical College, Agroha, Hisar, Haryana, India Mode of hysterectomy was decided on basis of clinical
Corresponding Author: Nidhi Jain, Assistant Professor, findings (uterus size and mobility of uterus), radiological
Department of Obstetrics and Gynaecology, Maharaja Agarsein findings, patient consent, and surgical expertise. In women
Medical College, Agroha, Hisar, Haryana, India, Phone: with the uterine size of < 12 weeks with the mobile uterus
9654822494, 9034096070, e-mail: nidhijain270587@gmail.com
and after informed consent, laparoscopic hysterectomy
World Journal of Laparoscopic Surgery, May-August 2018;11(2):59-63 59