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An intention‐to‐treat study of total laparoscopic hysterectomy
Author(s) -
Heaton Richard L.,
Walid M. Sami
Publication year - 2010
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.04.027
Subject(s) - medicine , abdominal hysterectomy , hysterectomy , laparoscopic hysterectomy , general surgery , laparoscopy , surgery
Objective To present the experience of a single provider with total laparoscopic hysterectomy (TLH) for benign gynecological pathology in order to promote awareness of the feasibility and merits of this minimally‐invasive procedure. Methods An intention‐to‐treat prospective study was conducted in a suburban gynecological practice in Central Georgia, USA. The study data were collected over a 7‐year period. Results From March 2003 to December 2009, 623 total laparoscopic hysterectomies including 379 pure laparoscopic hysterectomies (without additional procedures) were performed and 12 patients were referred to a gyn‐oncologist. The majority of our patients (93.6%) had a uterine weight of less than 500 g. The median operative time was 60 minutes for pure total laparoscopic hysterectomies. There were 14 intraoperative organ injuries of which 13 were repaired intraoperatively and no returns to the operation room within the first 24 hours. The average hospital charges for TLH were US $13 468 with an average length of stay of 1 day. The average charges for total abdominal hysterectomy were US $12 514 with an average length of stay of 2.3 days. Conclusion An advanced laparoscopist can replace the majority of inpatient total abdominal hysterectomies performed for benign indications with outpatient total laparoscopic hysterectomy.