Total laparoscopic hysterectomy: technique and complications of 830 cases

This study analyses the technique and complications from total laparoscopic hysterectomy.

Retrospective chart abstraction was performed on 830 consecutive patients operated on between 1996 and 2006. Demographic and surgical data were analyzed by ANOVA, chi-square, and Spearman and Pearson correlation techniques were used with significance set at P<0.05.

Of 830 consecutive patients, 5 (0.6%) were converted to laparotomy. Patients had a mean age of 50 (+/-11) years, a mean of 1.3 (+/-1.3) pregnancies, and a mean BMI of 27.6 (+/-6.8) kg/m(2). The mean surgical duration was 132 (+/-55) minutes, with mean blood loss of 130 (+/-189) mL and average hospital stay of 1.4 (+/-0.9) days. Duration of surgery, blood loss, and hospital stay all decreased with the surgeon's increasing experience. Reoperative complications occurred in 38 patients (4.7%). Urologic injuries were observed in 23 patients (2.6%), with 9 (1.1%) requiring reoperation.

This technique for TLH offers the benefits of minimally invasive surgery for patients needing hysterectomy, even those without vaginal capacity and uterine prolapse.