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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Total laparoscopic hysterectomy: the Brisbane learning curve
Andrea J Garrett1, Marcelo Carraro Nascimento, James L Nicklin
1Queensland Centre for Gynaecological Cancer, Royal Women's and Brisbane Hospital, Brisbane, Queensland, Australia.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|January 31, 2007
Summary
Total laparoscopic hysterectomy (TLH) is a safe procedure for gynaecological cancers. Our experience shows it can be established in a tertiary referral centre with low conversion rates and acceptable morbidity.
Area of Science:
- Gynaecological Oncology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Total laparoscopic hysterectomy (TLH) is increasingly utilized for gynaecological malignancies.
- Adoption of TLH in specialized cancer centers is a key development.
Purpose of the Study:
- To evaluate the initial experience with TLH in a tertiary referral center for gynecological cancer.
- To assess the safety and feasibility of TLH in this setting.
Main Methods:
- Retrospective analysis of 120 consecutive TLH cases.
- Patients divided into three groups of 40 for comparative analysis.
- Evaluation of operating time, blood loss, hospital stay, conversion rates, and morbidity.
Main Results:
- Low conversion rate to laparotomy (6.6%).
- Increasing rates of pelvic lymph node dissection over time (2.5% to 27.5%).
- Postoperative morbidity was highest in the second group of patients (25%).
Conclusions:
- Total laparoscopic hysterectomy (TLH) can be safely implemented in a tertiary gynecological cancer referral center.
- The procedure demonstrates feasibility and potential for increasing oncological staging completeness.
