Abdominal Hysterectomy - Vaginal Hysterectomy - Laparoscopically Assisted Vaginal Hysterectomy

The objective of this study was to compare the intraoperative and short-term postoperative complications of laparoscopic hysterectomy and total abdominal hysterectomy.

Study Design:

Retrospective study of 167 women who had laparoscopic hysterectomy and 119 women who had total abdominal hysterectomy. For assessing the learning curve, the laparoscopic hysterectomies were further subdivided to the first 30 hysterectomies and the later hysterectomies. For data analysis Student's t-test, chi2-test and Fisher's exact test were used.

Results:

There were no statistically significant differences between the two groups for age, body mass index, previous abdominal surgery, uterine weight, first postoperative day hemoglobin drop, blood transfusion and major or minor complications rate. Operation time was significantly longer for laparoscopic than abdominal hysterectomy (156+/-40 and 91.2+/-33 min, respectively; P<0.001) but the length of hospital stay was significantly shorter (3.9 and 6.55 days, respectively; P<0.001). The conversion rate of laparoscopic hysterectomy was 1.8% (three cases).

Conclusions:

Laparoscopic hysterectomy can be safely done even during the learning curve with a low and reasonable complication rate, and a shorter hospital stay but with longer operation time. As experience is gained the operation time, complication rate and hospital stay are decreased.

Please click on the required question.

• 1 Are heavy periods a common problem?
• 2 What is in my menstrual flow?
• 3 What range of menstrual cycle length is considered to be normal?
• 4 How can menstrual blood loss be measured?
• 5 How can I tell if my periods are abnormally heavy?
• 6 What could be the cause of my very heavy menstrual periods?
• 7 I have been sterilised. Could this be the cause of my heavy periods?
• 8 Should I have tests to find the reason for my heavy periods?
• 9 How will my heavy period problems be investigated?
• 10 What is meant by anaemia due to heavy periods?
• 11 What is intermenstrual bleeding?
• 12 What is a hysteroscopy and D and C?
• 13 What is cervical cautery?
• 14 What happens after the D and C?
• 15 What treatments are available for my heavy periods?
• 16 What are the medical treatments available for heavy periods?
• 17 How do the various medical treatments for heavy periods work?
• 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
• 19 What is a hysterectomy?
• 20 What are the indications for hysterectomy?
• 21 What are the risks (complications) of hysterectomy?
• 22 What is vault granulation?
• 23 What are the different types of hysterectomy?
• 24 Is it essential to remove the neck of the womb at hysterectomy?
• 25 Should my ovaries be removed or conserved during hysterectomy?
• 26 How long will I be in hospital when I have my hysterectomy?
• 27 I have had a hysterectomy. Do I still need to have smear tests?
• 28 What are the other surgical alternatives to hysterectomy?
• 29 How do endometrial ablation and hysterectomy compare?
• 30 Are there any psychological effects following hysterectomy?
• 31 How do we decide the best treatment for my period problems?
• 32 Could I have some recommended hysterectomy support groups?
• 33 Are there any support groups?
• Intermenstrual Bleeding - Bleeding between periods.

 

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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