Total laparoscopic hysterectomy: our experience from 2008 to 2012.

Objectives: Nowadays total laparoscopic hysterectomy (TLH) is a surgical procedure increasingly adopted for the treatment of benign and malign uterine disease. The aim of our study is to revise our recent experience of TLH.

Methods: This is a retrospective observational study conduced on 101 patients between 2008 and 2012. The surgical procedure has been performed by the same surgeon and with the same surgical technique. Patients with benign disease and I-II stage endometrial cancer (FIGO 2009) were considered eligible for the study. Data collected were concering weight, height, BMI, age; kind of disease; type of surgery performed and possible variants; surgery duration; intra-operative and post-operative complications.

Results: In 80 patients TLH was performed for benign disease, in 42 cases uterine fiboids; salpingo-oophorectomy has been performed in 37 patients; the mean surgical time was 81 minutes for benign disease and 112 minutes for malign disease. In 1 case conversion to laparotomy was required; in 5 patients we recorded post-surgical fever; in 1 patients we recorded deiscence of vaginal vault. None of the considered factors (age, BMI, kind of surgery) was significantly associated with increased frequency of intra- and post-operative complications.

Conclusions: Our clinical experience on TLH is increasing as years pass by, and our results are in line with those reported by other Centers. On the basis of our experience, in agreement with recently published data, we believe that vaginal vault closure should be performed through vaginal access.