[Total laparoscopic hysterectomy: descriptive study of institutional experience with 198 cases]

Total laparoscopic hysterectomy is a useful surgery in current gynecology, specially, in cases where abdominal access is indicated. Total laparoscopic hysterectomy performance has increased in recent years.

To analyze the clinical characteristics and surgical variables of patients undergoing laparoscopic total hysterectomy for benign disease, performed at the Instituto Nacional de Perinatologia Isidro Espinosa de los Reyes, between 2007 and 2009.

Retrospective, longitudinal and descriptive study. Medical records of all patients with a noncancer diagnosis underwent laparoscopic hysterectomy were reviewed, at the Instituto Nacional de Perinatologia, between January 1, 2007 and December 31, 2009.

594 hysterectomies were performed, of which 37.3% were by laparoscopic surgery, within these 89.1% were through the total laparoscopic hysterectomy technique. Surgical indications were 58.6% for fibroids, 23.2% abnormal uterine bleeding and 18.2% for adenomiosis. Studied variables revealed an average surgical time of 139 + 66.9 min (range: 75-225 min), average surgical bleeding of 119.7 +/- 60.5 mL (50-350 mL), average uterine longitude of 12.4 +/- 2 cm (8-16 cm), average uterine weight 222.7 +/- 113.8 g (90-860 g), and average hospital stay of 2.3 +/- 0.5 days (2-4 days), all of these results within the range reported in the literature.

Previous surgical interventions were observed as complications risk factors, 162 (81%) patients had previous surgeries, 29% with 2 c-sections, 20% with 3 or more and 27% had other non-obstetrical interventions. This technique is safe and reliable, it does not replace the vaginal access and with adequate training and equipment it may be performed in an efficient manner with satisfactory results in our population.