Comparison of Various Routes of Hysterectomy and their Outcomes

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Dr. Suman Puri
Dr. Bhanu Priya
Dr. Pooja Tandon

Abstract

Background: Hysterectomy means surgical removal of uterus. It can be performed abdominally, vaginally or with laparoscopic or robotic assistance or combined approaches. Though hysterectomy is one of the most commonly performed surgery but research on hysterectomy is limited in developing countries like India.



Objective: To compare the various surgical methods of hysterectomy for intraoperative and post operative clinical outcomes.



Materials and Methods: This study was conducted on patients who underwent hysterectomy (abdominal, vaginal or laparoscopic) for benign gynaecological diseases in the department of Obstetrics &Gynaecology, DMCH Ludhiana from 1st Feb 2015 to 31 Jan 2016. The procedural parameters and outcomes of different routes of hysterectomy were noted.



Results: One hundred patients were included in this study. The mean age of the cases was 49.26±9.216 years. The median parity of our cases was two. The different hysterectomiesthat were compared weretotal laparoscopic hysterectomy (TLH), laparoscopically assisted vaginal hysterectomy (LAVH), total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH). The operating time was shorter with the VH than with TAH, LAVH and TLH. Intraoperative blood loss was found to be higher with TAH than in LAVH, TLH and VH.



Conclusions: No single route of hysterectomy is the best. The route should be individualised for each patient keeping in mind various factors like age, parity, indication for surgery, size of the uterus and patients preference.



Keywords: Routes of hysterectomy; Abdominal hysterectomy; Vaginal hysterectomy; Total Laparoscopic hysterectomy; Laparoscopic assisted vaginal hysterectomy; Robotic assistance

Published Apr 2, 2019

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