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Introduction of the day case total laparoscopic hysterectomy (TLH) protocol
Sally Byford1, Drishti Madhok1, Paula Baldan1
1Obstetrics and Gynaecology, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Summary
Day case total laparoscopic hysterectomy (TLH) is feasible and safe in Australia, with most patients discharged same-day. This approach reduces hospital costs and improves efficiency while maintaining high patient satisfaction.
Area of Science:
- Minimally Invasive Surgery
- Gynecological Surgery
- Health Services Research
Background:
- Traditionally, total laparoscopic hysterectomy (TLH) involves a 1-2 day post-operative hospital stay.
- Day case TLH has demonstrated feasibility and safety internationally.
- This study introduces one of Australia's first day case TLH protocols at a tertiary Queensland hospital.
Purpose of the Study:
- To pilot the implementation of a day case TLH protocol.
- To assess the feasibility, safety, and patient satisfaction of same-day discharge after TLH.
- To evaluate the outcomes of a novel day case TLH protocol in an Australian tertiary hospital.
Main Methods:
- Retrospective audit of patients undergoing day case TLH.
- Primary outcome: length of post-operative hospital stay.
- Secondary outcomes: perioperative complications, re-presentation rates, and patient satisfaction via questionnaire.
Main Results:
- 94.81% of 77 patients were discharged on the same day.
- Average post-operative hospital stay was 7.72 hours (same-day discharge: 7.05 hours).
- No significant differences in complications or re-presentation rates compared to literature; patients reported high satisfaction.
Conclusions:
- Implementation of the day case TLH protocol is feasible, safe, and well-received by patients.
- Potential benefits include reduced hospital costs, improved theatre efficiency, and enhanced patient flow.
- The protocol maintains patient safety and satisfaction, offering a viable alternative to traditional inpatient care.
