Single-Centre Experience of Doing Safe Total Laparoscopic Hysterectomy: Retrospective Analysis of 1200 Cases

Abstract

Study Objective

Assessment of safety and feasibility of total laparoscopic hysterectomy in a high-volume tertiary care centre.

Design

Retrospective study design.

Setting

Tertiary care centre: Galaxy care Hospital, Pune, India.

Materials and Methods

This is a retrospective observational study conducted in a tertiary care resident training hospital in Pune which is a high-volume teaching hospital. 1200 total laparoscopic hysterectomy patients between July 2013 and June 2019 operated by a group of trained surgeons were analysed, and parameters, namely demography, indication of surgery, surgical time, intra-operative blood loss, post-operative complications, duration of hospital stay, discharge and follow-up, were studied.

Result(s)

A total of 1200 women who underwent total laparoscopic hysterectomy for various indications were included in the study. TLH was successfully performed in all women. Mean age of women was 45 years. 72.00% had a BMI between 18.5 and 24.9, 16.08% had a BMI between 25 and 29.9, 3.92% had a BMI of > 29.9 while 8% had a BMI < 18.5. Indications for surgery included uterine fibroid (33.08%), adenomyosis (22.25%), endometrial hyperplasia (14.33%), endometrial polyp (7%), endometriosis (3.33%), postmenopausal bleeding (9.25%), chronic PID (5.25%), prolapse (4.25%) and risk reduction surgery in 1.25%. 2.00% had intra-operative complications while 7.58% had post-operative complications which were identified and managed successfully.

Conclusion(s)

Advances and innovation in equipment, energy sources and surgical training have made TLH a well-tolerated and efficient surgery. Irrespective of the previous morbidity, pathology and uterine size, TLH is a duplicable and safe in a well-trained high-volume centre.

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Abbreviations

TLH:

Total laparoscopic hysterectomy

BMI:

Body mass index

LSCS:

Lower segment caesarean section

LH:

Laparoscopic hysterectomy

LAVH:

Laparoscopic-assisted vaginal hysterectomy

CO2:

Carbon dioxide

POD:

Post-operative day

LSCH:

Laparoscopic-assisted supracervical hysterectomy

LH:

Laparoscopic hysterectomy

N:

Number

PID:

Pelvic inflammatory disease

Fig:

Figure

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Corresponding author

Correspondence to Theertha S. Shetty.

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The authors declare that they have no conflicts of interest and nothing to disclose.

Ethical Approval

The study was approved by the Institutional Ethics Committee.

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Informed consent was taken from all human participants.

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Shailesh Puntambekar, MD at Galaxy Care Multispeciality Hospital, Pune, Above Ayurved Rasashala, 25-A, Karve Road, Pune, Maharashtra, India. Theertha S Shetty, MS at Galaxy Care Multispeciality Hospital, Pune, Above Ayurved Rasashala, 25-A, Karve Road, Pune, Maharashtra, India. Arjun Goel, MS at Galaxy Care Multispeciality Hospital, Pune, Above Ayurved Rasashala, 25-A, Karve Road, Pune, Maharashtra, India. Shruti Chandak, MS at Galaxy Care Multispeciality Hospital, Pune, Above Ayurved Rasashala, 25-A, Karve Road, Pune, Maharashtra, India. Shakti Panchal, DGO at Galaxy Care Multispeciality Hospital, Pune, Above Ayurved Rasashala, 25-A, Karve Road, Pune, Maharashtra, India.

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Puntambekar, S., Shetty, T.S., Goel, A. et al. Single-Centre Experience of Doing Safe Total Laparoscopic Hysterectomy: Retrospective Analysis of 1200 Cases. J Obstet Gynecol India (2020). https://doi.org/10.1007/s13224-020-01333-5

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Keywords

  • Total laparoscopic hysterectomy
  • High-volume centre
  • Safety