Abdominal hysterectomy versus total laparoscopic hysterectomy in cases of enlarged uterine size

Authors

  • Mohamed Attia Raslan Department Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt
  • Ahmed Tawfeek Morsi Department Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt
  • Hesham Mohamed Borg Department Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt
  • Stefano Angioni Department Obstetrics and Gynecology, Cagliari University, Cagliari, Italy
  • Hesham A. El Aziz Salem Department Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20220362

Keywords:

Large uterus, Multiple fibroids, Abdominal hysterectomy, TLH

Abstract

Background: Total laparoscopic hysterectomy (TLH) is a feasible, efficient way to manage benign uterine pathology, and is better than standard abdominal hysterectomy as it offers less postoperative discomfort, shorter hospitalization, rapid recovery, and early return to daily living activities.

Methods: A retrospective comparative cohort study was done on patients with abnormal uterine bleeding due to large myomas in the Department of Obstetrics and Gynecology, Tanta University Hospital, Tanta, Egypt, and Institute of Obstetrics and Gynecology, Cagliari University, Cagliari, Italy. Participants were classified into two groups. Group I (Laparoscopy group) included 20 patients for whom TLH was done. Group II (Laparotomy group) included 20 patients for whom open hysterectomy (OH) was done.

Results: Our result revealed that statistically significant differences were observed between the studied groups in post-operative Hb value, postoperative return of bowel sounds, and amount of blood loss however, prolonged duration of surgery was noticed in laparoscopic group than laparotomy group.

Conclusions: TLH is an accessible technique and an alternative to laparotomy when it was done by experienced surgeons for large uteri regardless of the site, size.

Author Biography

Mohamed Attia Raslan, Department Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt

gynecology and obsteterics

References

Committee Opinion No 701: Choosing the Route of Hysterectomy for Benign Disease. Obstet Gynecol. 2017;129(6):e155-9.

Sutasanasuang S. Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective comparative study Comparative Study. J Med Assoc Thai. 2011;94(1):8-16.

Sinha R, Sundaram M, Lakhotia S, Mahajan C, Manaktala G, Shah P. Total Laparoscopic Hysterectomy for Large Uterus. J Gynecol Endosc Surg. 2009;1(1):34-9.

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Willem Mol JB, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015;2015(8):CD003677.

Kehde BH, Bruno J, Herendael V, Tas B, Jain D, Helsen K, et al. Large uterus: what is the limit for a laparoscopic approach? Autops Case Rep. 2016;6(1):51-6.

Ceccaroni M, Roviglione G, Pesci A, Quintana S, Bruni F, Clarizia R. Total laparoscopic hysterectomy of very enlarged uterus (3030 g): case report and review of the literature. Wideochir Inne Tech Maloinwazyjne. 2014;9(2):302-7.

Puntambekar SP, Wagh GN, Puntambekar SS, Sathe RM, Kulkarni MA, Kashyap MA, et al. A Novel Technique of Total Laparoscopic Hysterectomy for Routine Use: Evaluation of 140 Cases Int J Biomed Sci. 2008;4(1):38-43.

Kai-Yun W, Srithean L, Kuan-Gen H, Hsuan S, Chih-Feng Y, Chyi-Long L. Laparoscopic hysterectomies for large uteri Taiwanese. J Obstetr Gynecol. 2011;50(4):411-4.

Summitt RL Jr, Stovall TG, Steege JF, Lipscomb GH. A multicentered randomized comparison of laparoscopic assisted vaginal hysterectomy and abdominal hysterectomy in abdominal hysterectomy candidates. Obstet Gynaecol 1998;92:321-6.

Okhunov Z, Yoon R, Lusch A, Spradling K, Suarez M, Kaler KS, et al. Evaluation and Comparison of Contemporary Energy-Based Surgical Vessel Sealing Devices. J Endourol. 2018;32(4):329-37.

Walid MS, Heaton RL. Total Laparoscopic Hysterectomy for Uteri Over One Kilogram JSLS. 2010;14(2):178-82.

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Published

2022-02-28

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Original Research Articles