[Vaginally assisted laparoscopic hysterectomy vs. abdominal hysterectomy. Initial experience]

A longitudinal prospective study was performed including 22 patients that were submitted to hysterectomy, for diverse being uterine pathologies, between March 1st. 1995 and until August 31st. 1996, in private practice at México City. The patients were divided into two groups: I) Patients submitted to total abdominal hysterectomy (TAH), 10 patients, and II) Patients submitted to vaginally assisted laparoscopical hysterectomy (VALH), 12 patients. The inclusion criteria for each group depended on the patient's weight: those with an overweight of more than 20% were included in group I, and those with an overweight of less than 20% were included in group II. All the patients were comparable in age, gestational history and surgical abdominal history. In our experience those submitted to TAH (4.2 weeks) or those submitted to VALH converted into laparotomy (3.5 weeks). In group I three patients presented minor complications (postoperative hemoglobin of less than 10 g/dl--two cases--and febrile morbidity secondary to minor lung athelectasis--one case--) that were solved with conventional measures. The mean surgical time was similar between groups I and II (159 and 152 minutes respectively) and longer in the VALH converted into laparotomy (240 minutes). The mean hospital cost was similar for groups I and II (18.6 thousand pesos). The hospital stay was similar in all cases (3.6, 3 and 3.5 days for groups I, II and the VALH converted cases, respectively). Those patients submitted to VALH electively stayed in the hospital for three day, even though their postsurgical progress was evident, so they could have been discharged of the hospital 24 hours after the surgery.