OUTCOMES OF TOTAL LAPAROSCOPIC HYSTERECTOMY BASED ON UTERINE SIZE IN CASES OF UTERINE LEIOMYOMAS
DOI:
https://doi.org/10.55519/JAMC-S4-14061Keywords:
Uterine Leiomyomas, Uterine size, Laparoscopic hysterectomy, OutcomesAbstract
Background: Uterine leiomyoma's, also known as fibroids, are benign monoclonal tumors that originate from the soft tissue of the myometrium. Extracellular factors such as proteoglycans, fibronectin, and collagen characterized the tumors. The present study aimed to determine outcomes of total laparoscopic hysterectomy based on uterine size in uterine leiomyoma's cases. Methods: This cross-sectional study investigated 60 uterine leiomyomas patients who underwent total laparoscopic hysterectomy in the Department of Gynecology and Endoscopic Unit of Patel Hospital, Karachi from January 2023 to December 2023. Patients were distributed based on uterine weight are as follows; Group-A (<14 weeks and <500 gms) and Group B (‰¥14 weeks and >500gms). All the patients with benign uterine pathology undergoing total laparoscopic hysterectomy were enrolled. Variable measured included age, preoperative characteristics, body mass index, and duration of surgery, blood loss, and uterine weight. SPSS version 21 was used for descriptive statistics. Results: The overall mean age, and body mass index was 45.48±4.97 years, and 27.68±3.76 kg/m2, respectively. The mean duration of surgery was 107.17±30.56 minutes. The mean duration of surgery in Group-A (n=30) and Group B (n=30) was 106.78±28.96 and 107.56±32.16 minutes, respectively. Hypertension was the most prevalent comorbidities followed by diabetes. The mean uterus size (weeks + kg) was 13.23±2.66 and 373.495±147.92. Mean total estimated blood was 73.02±32.36 ml. It has been observed that duration of surgery and uterus size was lower in Group-A than Group-B. Conclusion: The present investigation observed that total laparoscopic hysterectomy (TLH) are optimal when the uterus weighs less than 500 gms. Additionally, uterus weight <500 gms had lower body mass index, duration of surgery and blood loss as compared to uterus weight >500 gms.
References
Ajjammanavar V, Vinodini P, Jayashree S. Outcome of total laparoscopic hysterectomy in relation to the size of the uterus. Int J Reprod Contracept Obstet Gynecol 2019;8:74-8.
Kumar GS, Lekkala S. Complications after a total laparoscopic hysterectomy: a study in tertiary care unit in Telangana, India. Int Surg J 2016;3(3):1141-5
Nakayama K, Tsukao M, Ishikawa M, Ishibashi T, Nakamura K, Sanuki K, et al. Total laparoscopic hysterectomy for large uterine cervical myoma. Molecular and Clinical Oncology. 2017; 6:655-660.
Ujita M, Sumitomo M, Takakura M, Kawamura Y, Takakura K, Konishi I. An attempt to simplify total laparoscopic hysterectomy procedures at our hospital. Japanese Journal of Gynecologic and Obstetric Endoscopy. 2017; 12: 293-298.
Yushimura Y, Nakayama K, Sawada K, Yamashita H, Nakamura K, Ishibashi T, et al. A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy. Clinical and Experimental Obstetrics & Gynecology. 2021; 48: 194-197.
Bakay K, Yavuzcan A, Kalkan Ü, Yalcin I, Hatırnaz Ş, Başbuğ A, et al. Hypogastric artery ligation in laparoscopic hysterectomy: results from a randomized controlled trial. Clinical and Experimental Obstetrics & Gynecology. 2021; 48: 1304-1310.
Okumura A, Kondo E, Nii M, Kubo-Kaneda M, Yoshida K, Ikeda T. Comparison of surgical outcomes between robot-assisted laparoscopic hysterectomy and conventional total laparoscopic hysterectomy in gynecologic benign disease: a single-center cohort study. Journal of Robotic Surgery. 2023 Oct;17(5):2221-8.
Faraz A, Gul A, Bangash A, Gulab N, Khan SJ. Total laparoscopic hysterectomy versus vaginal assisted laparoscopic hysterectomy for benign uterine conditions: A prospective trial. The Professional Medical Journal. 2024 May 31;31(06):892-8.
Agarwal M, Sinha S, Singh S, Haripriya H, Roy I. Surgical Morbidity of Laparoscopic Hysterectomy versus Abdominal Hysterectomy: A Retrospective Overview. Gynecology and Minimally Invasive Therapy. 2023 Jul 1;12(3):161-5.
Isono W, Hiratsuka D, Tsuchiya A, Fujimoto A, Nishii O. Comparison of robotic-assisted laparoscopic hysterectomy to total laparoscopic hysterectomy in terms of operational complications at a regional institution: A retrospective study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X. 2023 Jun 1;18:100187.
Driessen SR, Van Zwet EW, Haazebroek P, Sandberg EM, Blikkendaal MD, Twijnstra AR, et al. A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes. Am J Obstet Gynecol. 2016; 215(6):754.e1-8
Allam IS, Makled AK, Gomaa IA, El Bishry GM, Bayoumy HA, Ali DF. Total laparoscopic hysterectomy, vaginal hysterectomy and total abdominal hysterectomy using electrosurgical bipolar vessel sealing technique: A randomized controlled trial. Arch Gynecol Obstet. 2015; 291(6):1341-5
Zafar SA, Iqbal J, Tahira T, Javed N, Noor S. Laparoscopic Hysterectomy; Comparison of Total Laparoscopic Hysterectomy versus total abdominal hysterectomy: An assessment of the learning curve; Randomized Control Study. Professional Med. J 2018; 25(1):26-9. DOI: https://doi.org/10.29309/TPMJ/2018.25.01.532.
Macciò A, Chiappe G, Kotsonis P, Nieddu R, Lavra F, Serra M, et al. Surgical outcome and complications of total laparoscopic hysterectomy for very large myomatous uteri in relation to uterine weight: a prospective study in a continuous series of 461 procedures. Arch Gynecol Obstet. 2016; 294(3):525-31.
Allam IS, Makled AK, Gomaa IA, El Bishry GM, Bayoumy HA, Ali DF. Total laparoscopic hysterectomy, vaginal hysterectomy and total abdominal hysterectomy using electrosurgical bipolar vessel sealing technique: A randomized controlled trial. Arch Gynecol Obstet. 2015; 291(6):1341-5.
Lkhagvadulam D, Amarsanaa. Comparison of total laparoscpic hysterectomy, laparoscopic assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy. Mong Med Sci J. 2014; 167(1):23-6.
Kehde BH, van Herendael BJ, Tas B, Jain D, Helsen K, Jochems L. Large uterus: what is the limit for a laparoscopic approach? Autops Case Rep. 2016;6(1):51-6.
Imran S, Ali S, Samreen Z. Comparison of Outcomes of Total Laparoscopic Hysterectomy versus Total Abdominal Hysterectomy. Journal of Shalamar Medical & Dental College-JSHMDC. 2023 Jun 27;4(1):24-9.
Locher JA, Chrysostomou M, Djokovic D, Libhaber E, van Herendael BJ, Chrysostomou A. The impact of obesity on vaginal hysterectomy and laparoscopically-assisted vaginal hysterectomy outcomes: A randomised control trial. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2023 Aug 1;287:227-31.
grawal S, Chen L, Tergas AI, Hou JY, St Clair CM, Ananth CV, Neugut AI, Hershman DL, Wright JD. Characteristics associated with prolonged length of stay after hysterectomy for benign gynecologic conditions. Am J Obstet Gynecol. 2018 Jul;219(1):89.e1-89.e15. doi: 10.1016/j.ajog.2018.05.001.
Güven CM, Uysal D, Kolsuz Z, Yilmaz B. Surgical outcomes of intraabdominal versus vaginal approach for uterine manipulation during total laparoscopic hysterectomy. Medicine. 2023 Jun 2;102(22):e33927.
Lee S.H, Oh S.R, Cho Y.J, Han M, Park JW, Kim SJ, et al. Comparison of vaginal hysterectomy and laparoscopic hysterectomy: A systematic review and meta-analysis. BMC Women's Health. 2019; 19(83):1-12.6
Uwais A, Al-Abadleh A, Jahameh M, Satari A, Al-Hawamdeh Q, Haddadin S. A Comparison between Total Abdominal Hysterectomy versus Total Laparoscopic Hysterectomy. Gynecology and Minimally Invasive Therapy. 2024 Jan 1;13(1):43-7.
Aboulfotouh ME, Chaalan F, Mohammed AF. Laparoscopic hysterectomy versus total abdominal hysterectomy: A retrospective study at a tertiary hospital. Gynecol Surg 2020;17:1'‘5.
Gupta DP, Chandra DS, Kulshrestha DR, Kulshrestha DM, Ghai DS. A comparative study between total laparoscopic hysterectomy (TLH) and conventional total abdominal hysterectomy (TAH) in nonneoplastic uterine diseases. Int J Clin Obstet Gynaecol 2020;4:188'‘91.
Yang J, Fan X, Gao J, Li D, Xu Y, Chen G. Cost effectiveness analysis of total laparoscopic hysterectomy versus total abdominal hysterectomy for uterine fbroids in Western China: A societal perspective. BMC Health Serv Res 2022;22:252.
Nagata H, Komatsu H, Nagaya Y, Tsukihara S, Sarugami M, Harada T, et al. Comparison of total laparoscopic hysterectomy with abdominal total hysterectomy in patients with benign disease: A retrospective cohort study. Yonago Acta Med 2019;62:273'‘7
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nazneen Hameed, Samina Saleem Dojki, Alia Bano, Mahgul Hameed, Mehreen Hameed
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
