A 9-year experience of laparoscopic hysterectomy in a UK district general hospital

Abstract

Hysterectomy is the commonest major gynaecological operation. Laparoscopic hysterectomy now offers a means of converting an otherwise abdominal approach into a vaginal procedure. A UK district general hospital has evaluated its experience in laparoscopic hysterectomy over 9 years, starting at a point when abdominal hysterectomy was a norm in the UK. Three hundred and sixty-three women underwent laparoscopic hysterectomy from January 1993 to January 2002. Operating time averaged at 86.4 min while the hospital stay was 2.7 days. For 2 years ENDO GIA was used. Two hundred and ninety-seven cases of laparoscopic hysterectomy were performed where the cardinal and uterosacral ligaments were transected. Bowel complications were 0.55%, ureteric complications were 0.55% while bladder complications were 0.826% and one patient died . The overall complication rate (minor and major) was 8.5%. These rates are comparable with other studies of abdominal and laparoscopic hysterectomies. The uptake of laparoscopic hysterectomies continues to be low in the United Kingdom. To offer the benefits of laparoscopic hysterectomy it is important to dramatically increase the uptake of the minimal access route by aiming to change practice and training for this procedure. © Springer-Verlag 2005.