Publication:

Comparison of total abdominal, vaginal and total laparoscopic hysterectomy

Background Open abdominal hysterectomies was one of the most common and traditional surgical procedure for the removal of uterus in women for the treatment of benign gynecological disease. Vaginal hysterectomy, on the other hand is one of the minimally invasive surgeries which provides less post operative pain and more rapid recovery with lesser number of days of hospital stay. Laparoscopic hysterectomy results in less blood loss than either vaginal or abdominal surgeries and is also more achievable in nulliparous and obese women.

Methods 198 women who had total abdominal, vaginal or laparoscopic hysterectomy were included into the study. The route of hysterectomy is guided by the surgical indication for hysterectomy, patient anatomy, data that support the selected procedure, informed patient preference, and the surgeon’s expertise. All the surgeries were done under general anaethesia and cefotaxim was given as the prophylactic antibiotic prior to the surgery.

Results Most of the women who had come to the hospital for hysterectomy were above the age of 40 years. Most of the women had come for hysterectomy due to dysfunctional uterine bleeding (DUB), followed by Endometriosis and pelvic pain. Most of the patients who underwent laparoscopic surgery were in the hospital for less than 5 days while the maximum duration of hospital stay was in the patients who had abdominal surgery. The number of patients who received blood transfusion among all the cases was minimal, though the least requirement was seen among the patients who underwent laparoscopic surgery. 2 patients who had abdominal surgery had to be readmitted due to complications.

Conclusions Laparoscopic surgeries result in a faster recovery time and lesser hospital stay and minimal pain and complications compared to abdominal and even vaginal hysterectomy. However, this type of a surgery requires surgeon’s experience and expertise.