ABSTRACT

Hysterectomy is the most common major gynecologic procedure. Although majority of hysterectomies is performed through laparotomy, total laparoscopic hysterectomy is increasing in the world. In this study, the patients who underwent total laparoscopic hysterectomy in our clinic were evaluated.

The datas of patients who underwent total laparoscopic hysterectomy due to benign or malignant gynecologic disease in our clinic between January 2014 and January 2016 were evaluated retrospectively. The demographic datas of patients including age, parity, body-mass index and history of previous operation were recorded. Indication of hysterectomy, additional surgery to hysterectomy, total operation time, mean blood loss, pre-operative and postoperative hemoglobin levels, uterus weight, perioperative and postoperative complications and hospital stay were recorded. The results were evaluated according to current literature.

One hundred and one patients were included in this study. The mean age of patients was 51.7 (42-73), the mean body-mass index was 26,3 (21.2-38,3) and the median of parity was 3 (0-8). 27 (26.7%) of 101 patients had previous abdominal surgery. The most common indication for hysterectomy was abnormal uterine bleeding in 33 of 101 patients (32.6%). Bilateral salpingo-oophorectomy was performed in 65 (64.4%) patients, bilateral salpingectomy was performed in 29 (28.7%) patients, bilateral salpingooophorectomy with bilateral pelvic lymphadenectomy was performed in 6 (5.9%) patients who had endometrial cancer and sacrocolpopexy was performed in 1 (1%) patient with uterine prolapse, in addition to hysterectomy. Mean uterus weight was 195 (95-530) g and mean total operation time was 110 (75-210) m. Mean blood loss was 110 (10- 300) cc. Mean hospital stay was 2,1 (1-3) d. One major complication was detected in 1 (1%) patient and one minor complication was detected in 2 (2%) patients.

Total laparoscopic hysterectomy is a feasible and a safe operation. While total operation time was long initially, as surgery team gets experienced, it gets shorter.