Single-Centre Experience of Doing Safe Total Laparoscopic Hysterectomy: Retrospective Analysis of 1200 Cases.

Study Objective: Assessment of safety and feasibility of total laparoscopic hysterectomy in a high-volume tertiary care centre.

Design: Retrospective study design.

Setting: Tertiary care centre: Galaxy care Hospital, Pune, India.

Materials And Methods: This is a retrospective observational study conducted in a tertiary care resident training hospital in Pune which is a high-volume teaching hospital. 1200 total laparoscopic hysterectomy patients between July 2013 and June 2019 operated by a group of trained surgeons were analysed, and parameters, namely demography, indication of surgery, surgical time, intra-operative blood loss, post-operative complications, duration of hospital stay, discharge and follow-up, were studied.

Results: A total of 1200 women who underwent total laparoscopic hysterectomy for various indications were included in the study. TLH was successfully performed in all women. Mean age of women was 45 years. 72.00% had a BMI between 18.5 and 24.9, 16.08% had a BMI between 25 and 29.9, 3.92% had a BMI of > 29.9 while 8% had a BMI < 18.5. Indications for surgery included uterine fibroid (33.08%), adenomyosis (22.25%), endometrial hyperplasia (14.33%), endometrial polyp (7%), endometriosis (3.33%), postmenopausal bleeding (9.25%), chronic PID (5.25%), prolapse (4.25%) and risk reduction surgery in 1.25%. 2.00% had intra-operative complications while 7.58% had post-operative complications which were identified and managed successfully.

Conclusions: Advances and innovation in equipment, energy sources and surgical training have made TLH a well-tolerated and efficient surgery. Irrespective of the previous morbidity, pathology and uterine size, TLH is a duplicable and safe in a well-trained high-volume centre.