Can laparoscopic assisted hysterectomy safely replace abdominal hysterectomy?

Abstract

Objective: To evaluate the feasibility, safety and advantages of laparoscopic hysterectomy.

Design: Retrospective review.

Setting: St. John of God Hospital, Perth, Australia.

Subjects: Fifty-four women scheduled to undergo laparoscopic hysterectomy for a variety of benign gynaecological conditions.

Main outcome measures: Failure to complete the operation laparoscopically, time taken in theatre, incidence of febrile morbidity, incidence of major complications, duration of post-operative stay in hospital, interval from operation to full activity and return to work.

Results: Laparoscopic hysterectomy was attempted in 54 women. A total of 53 operations were completed laparoscopically with one conversion to laparotomy because of haemorrhage. Major complications occurred in two women, both of whom required further surgery. There were four cases of febrile morbidity. The average duration of post-operative stay was four days (range 2-9), with return to normal activity in two and a half weeks and to work in three weeks.

Conclusions: Laparoscopic hysterectomy can be successfully achieved in most women selected for the procedure. Serious complications are inherent to some of the techniques used, but these can be overcome by modifications. Proper training and supervision in laparoscopic surgery is essential during the learning phase of the technique. There are considerable advantages to eligible women in terms of a rapid return to normal activities and work.