Minilaparotomy hysterectomy: a worthwhile alternative

To report the clinical merits and usefulness of minilaparotomy hysterectomy in comparison to the traditional abdominal approach.

A comparative study to review perioperative and postoperative outcomes and complications was conducted in 98 patients undergoing abdominal hysterectomy through Pfannenstiel incision for benign gynecological disease or pre-invasive pathology. Fifty of these patients (Group I) underwent hysterectomy by minilaparotomy approach (≤5 cm incision) and 48 patients (Group II) had standard/conventional methodology (>6 cm incision).

Though there were no statistically significant differences between the patients' profile as well as the size and weight of the removed uterus in the two groups, the mean operating time was 41.3 min in Group I and 77.5 min in Group II (P<0.01) and the mean postoperative hospital stay of 3.1 days in Group I was significantly lower than in Group II patients (5.4 days), P<0.01. There was no major complication or mortality in either of the groups and the composite morbidity encountered was 4% versus 33.33% in Groups I and II, respectively. Two of the patients in Group II required blood transfusion whereas none of the patients in Group I had estimated blood loss over 500 mL.

Minilaparotomy hysterectomy through ≤5 cm Pfannenstiel incision provides an appealing, effective, expeditious, minimal access and less invasive cost-effective option/alternative to the traditional abdominal approach obviating the need for any additional expensive equipment and, above all, improves upon the perioperative outcome, notwithstanding, whatsoever, on the quality of surgery.