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Updated: Feb 24, 2026
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Published on: September 12, 2025
Comparison of Perioperative Outcomes in Conventional Approach versus Posterior Approach for Uterine Artery Ligation
Kanhu Charan Dash1, Nilaj Bagde2, Ashish Khobragade2
1Department of Gynecological Oncology, AHPGIC, Chhattisgarh, India.
Background:
Total laparoscopic hysterectomy (TLH) is commonly performed for benign gynecological conditions, with uterine artery ligation being a critical step due to its role as the major blood supply to the uterus.
Aims And Objectives:
To compare perioperative outcomes of conventional versus posterior uterine artery ligation during TLH.
Materials And Methods:
A randomized controlled trial including 60 women meeting the inclusion criteria were selected and randomized into two different groups: Group A (conventional approach) and Group B (posterior approach), with 30 patients in each group. Baseline characteristics, including age, parity, BMI, previous surgery history, comorbidities, and menopausal status, were similar across groups.
Results:
Post-operative drop in hemoglobin level in each group has a significant difference; the hemoglobin drop was significantly greater in Group A (1.58 g/dl) compared to Group B (0.90 g/dl, P < 0.001). Estimated blood loss was also significantly higher in Group A (109.47 ml) than in Group B (78.33 ml, P < 0.001), reflecting reduced vascular injury and bleeding with the posterior approach. Additionally, operative time was noted to be shorter in Group B than Group A. The Mean of the operative time (minutes) in group A was 102.07 (10.22) and in group B was 92.27 (7.71). It was significantly higher in group A (P-value <0.001).
Conclusion:
findings suggest that the posterior approach for uterine artery ligation during TLH is associated with less blood loss, reduced hemoglobin drop, and shorter operative times, indicating it may be a safer and more efficient method than the conventional approach.
