Comparison of total laparoscopic Hysterectomy versus vaginal hysterectomy for benign non prolapsed uterus

Abstract

Background : Vaginal hysterectomy is a well established and time tested procedure which is being done since the last 150 years and thus has been refined to a great degree, but it has been less successful due to lack of experience and enthusiasm among Gynaecologists, due to a misconception that the abdominal route is safer and easier. Objective: The present study was undertaken to compare outcomes of conventional vaginal hysterectomy and total laparoscopic hysterectomy in women with benign non prolapsed uterus. Methods: Total 50 cases of non prolapsed uterus requiring hysterectomy were systematically allocated into two groups of 25 patients in each group, (Vaginal and total laparoscopic hysterectomy group). All patients underwent pelvic ultrasound (USG). Surgical techniques, operating time, estimated blood loss and/or episodes of accidental bleeding requiring intervention intra-or post-operatively were compared. Other factors such as post operative pain, post-operative complications, conversion to laparotomy, and length of hospital stay were also recorded for each case. Results: We found that blood loss in vaginal hysterectomy was more than in total laparoscopic hysterectomy. Post-operative pain and post complications were also more in the vaginal hysterectomy group. Operation time was however more in the total laparoscopic hysterectomy group but recovery time was less. Conclusion: In the present study, we found advantages of laparoscopic hysterectomy over vaginal hysterectomy in terms of lesser blood loss, postoperative pain and postoperative complications, a larger study with emphasis on long term effects may be essential to establish superiority of total laparoscopic hysterectomy over vaginal hysterectomy.