Total laparoscopic hysterectomy versus non–descent vaginal hysterectomy: An observational study
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2017, Vol 24, Issue 2
Abstract
Background: Hysterectomy is one of the most common surgery performed by Gynaecologist. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus total laparoscopic hysterectomy (TLH) and non descent vaginal hysterectomy (NDVH) has gained popularity. Laparoscopic surgeries requires high-tech Operation Theater (OT) setup, sophisticated instruments and surgical skills. Vaginal hysterectomy descent or non descent is a simple and effective technique for benign pathologies of uterus. Objective: This study was conducted to compare Total Laparoscopic Hysterectomy and Non Descent Vaginal Hysterectomy with reference to fall in blood haemoglobin level, duration of operation, weight of uterus, post-operative complication and post-operative ambulation. Material and Method: This is a prospective comparative (observational) study done among fifty patients who underwent total laparoscopic hysterectomy or non–descent vaginal hysterectomy for various indications in the Department of Obstetrics and Gynaecology in Silchar Medical College and Hospital, Silchar, Assam (India) from January to December 2015. The patients having at least two children, aged more than 35 years and size of the uterus less than 12 weeks size were included. The patients were monitored and data collected included indications of hysterectomy, type of hysterectomy, duration of operation ̦amount of blood loss weight of the uterus etc. Results: TLH cases had lesser blood loss than NDVH cases. NDVH took shorter operating time (96.8 min) than TLH (101.2 min). The Patients who underwent TLH ambulated early (22.4hrs) in comparison to NDVH group (27.24hrs). NDVH group had lesser complications in comparison to TLH. Conclusion: NDVH is better in its approach through natural orifice, faster and less expansive. In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, facilities available in the hospital and preference of patient as well as surgeon. In peripheral hospitals where resources are limited NDVH takes upper hand than TLH as it is more economic, takes lesser time, requires less surgical techniques in comparison to TLH.
Authors and Affiliations
A B Fuzayel, Banasree Bhadra, N Choudhury, D J Shyam
Keywords
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