Clinical Profile of Patients Undergoing Total Laparoscopic Hysterectomy

Abstract

Introduction: Total laparoscopic hysterectomy (TLH) has emerged as a preferred alternative to abdominal hysterectomy for benign gynaecological conditions owing to its well-known benefits. With increasing use of laparoscopic techniques, it is important to evaluate the clinical profile and surgical outcomes of the patients undergoing total laparoscopic hysterectomy.
Methods: This descriptive study was conducted at Kathmandu Model Hospital- Institute of Health Sciences over 5 months period after taking ethical approval. All patients undergoing TLH for benign indication were included in the study. Sociodemographic and clinical characteristics, operative details and immediate postoperative complications were recorded in a predesigned proforma. Data were analysed using SPSS version 20. P-value of <0.05 was considered statistically significant.
Results: A total of 73 patients underwent TLH during the study period. The mean age and bod mass index was 46±5.83 years and 28.07±3.94 kg/m2 respectively. The most common presenting symptom was heavy menstrual bleeding (63%, n=46). Fibroid uterus (52.1%, n= 38) was the leading indication for TLH. The mean operative time was 149.04±40.33 minutes. A statistically significant association was observed between increasing uterine weight and longer operative time (p=0.001). The overall complication rate was 23.28% with no bowel or urinary tract injuries.
Conclusion: Total laparoscopic hysterectomy is a safe and feasible options for benign gynaecological conditions, even in patients with higher body mass index and larger uterine size. Despite longer operative time, it has favourable perioperative outcome with acceptable complication rates.