Introduction of the day case total laparoscopic hysterectomy (TLH) protocol.

Background: Traditionally total laparoscopic hysterectomy (TLH) patients are admitted for 1-2 days post-operatively. Day case TLH has been proven to be feasible and safe in other countries; however, this tertiary Queensland hospital is one of the first Australian institutions to introduce a day case TLH protocol.

Aim: To pilot the implementation of our day case TLH protocol assessing the feasibility, safety and patient satisfaction of same-day discharge.

An Unexpected Case of Intrapartum Pneumomediastinum.

The dyad of spontaneous pneumomediastinum and subcutaneous emphysema is collectively known as Hamman's syndrome. This rare complication is known to occur during the intrapartum period and its aetiology has been linked to the Valsalva maneuver in the second stage of labour. Nitrous oxide inhalation increases the risk.