Total laparoscopic hysterectomy for benign disease: outcomes and literature analysis

Abstract

Objective: To analyze surgical outcomes of total laparoscopic hysterectomy (TLH) for benign disease. Methods: Retrospective analysis of 361 consecutive cases, prospectively collected from January 2012 to June 2016, of women who underwent TLH in St. Chiara Hospital in Trento, Italy. Clinical, demographic, surgical, and intra and perioperative data were recorded. Complications were graded on the Clavien-Dindo morbidity scale. Data were compared with literature. Statistical analysis was performed with SPSS (SPSS Chicago, IL). Findings: Main indication for TLH was uterine fibromatosis (78.6%). Mean uterine size was 327 ± 249 g (range 30–1800 g). Mean operating time was 115 ± 36 min. No laparotomy conversion occurred. Mean length of hospital stay was 2.6 ± 1.1 days (range 1–12 days). Complications requiring surgical intervention in general anesthesia occurred in 3 patients (0.8%): 1 (0.3%) hydroureteronephrosis, 1 (0.3%) bowel adhesions, and 1 (0.3%) port side hernia; complication requiring surgical intervention without general anesthesia occurred in 6 patients (1.6%): 2 (0.6%) hydroureteronephrosis, 1 (0.3%) vaginal cuff dehiscence, and 3 (0.8%) vaginal cuff bleeding. Conclusions: Total laparoscopic hysterectomy is a procedure with a low incidence of complications. Our data compare favorably with the data of the other listed studies.