Total laparoscopic hysterectomy (TLH) with endosuturing compared with conventional technique using energy sources.

Area of Science:

• Minimally Invasive Gynecological Surgery
• Surgical Techniques
• Laparoscopic Procedures

Background:

• Total laparoscopic hysterectomy (TLH) is a standard surgical procedure.
• Traditional TLH often utilizes energy sources for tissue dissection and vessel sealing.
• Exploring alternative techniques like intra-corporeal endosuturing is crucial for advancing surgical practice.

Purpose of the Study:

• To demonstrate the technique of TLH using intra-corporeal endosuturing with simple sutures.
• To compare this technique with TLH performed using energy sources.
• To evaluate differences in operative time, blood loss, postoperative stay, and pain scores.

Main Methods:

• A retrospective study included 586 cases of TLH for benign gynecological conditions.
• 287 cases used intra-corporeal endosuturing (Group 1), and 299 used energy sources (Group 2).
• Baseline matching for BMI, indications, uterine size, previous surgeries, and comorbidities ensured comparability between groups (172 patients each).

Main Results:

• No significant differences were observed in operative time (104.1 vs 107.6 mins), blood loss (78.9 vs 99.7 ml), pain scores (2.5 vs 2.7), or postoperative stay (2.05 vs 2.07 days) between the groups.
• Uterine size was identified as a key factor influencing operative time and blood loss.
• Patient age averaged 48.24 ± 6.76 years.

Conclusions:

• TLH with intracorporeal endosuturing is a safe and viable alternative to energy-based methods.
• The technique provides comparable outcomes to traditional TLH using energy sources.
• Further advancements in suturing devices may enhance efficiency and patient acceptance.