Citation Information :
Kadam DD, Gurjar B. Diagnosis Based Technique of Hysterectomy: Comparison among Laparoscopic and Nondescent Vaginal Hysterectomy. J Obstet Gynaecol 2024; 2 (1):8-11.
Objectives and background: The objectives of this investigation encompass the indications prompting uterine removal for various medical reasons. The current inquiry systematically examines the factors influencing the decision for hysterectomies and subsequently reports the corresponding clinical outcomes. The primary aim is to conduct a comparative analysis of clinical results between two methods of hysterectomy, namely total laparoscopic hysterectomy (TLH) and nondescent vaginal hysterectomy (NDVH).
Materials and methods: This comparative study, conducted in a Tertiary Care Center, meticulously considers crucial intraoperative parameters, such as operating time, blood loss attributable to the procedure, and bladder/bowel injury, as well as pain scores assessed by the visual analogue scale (VAS), in conjunction with the duration of hospital stay. Statistical analyses include the application of the Chi-square test and other fundamental statistical procedures.
Results: With an average age of 46 years, it was observed that the time required for performing TLH was significantly shorter than NDVH. Similar trends were identified in parameters such as blood loss, and postoperative pain scores at the 3rd hour, 1st day, and 2nd day. The total hospital stay (in days) for NDVH was notably longer compared to TLH.
Discussion: The findings of the present study suggest that under optimal conditions, including suitable facilities, surgical expertise, and proper indications, TLH could be considered the preferred route for hysterectomy. Conversely, in a developing nation like India, NDVH offers a distinct advantage, especially when considering the specific indications for surgery, making it the preferred route for benign uterine conditions.
Conclusion: The study concludes that the choice of the hysterectomy route may be contingent upon the specific circumstances of the procedural location.
Clinical significance: The decision regarding the appropriate route for the operation can be made with careful consideration of the factors elucidated in this study.
Jones HW, Rock JA. Te Linde's operative gynecology. Lippincott Williams & Wilkins; 2015. Chapters 22,23.
Zahra A, Foroogh B, Haydeh S, et al. Comparison of laparoscopically assisted vaginal hysterectomy and total abdominal hysterectomy. Medical journal of the Islamic republic of Iran (mjiri) [internet] 2008;22(1):22–28. Available from: https://sid.Ir/paper/294459/en.
Moradan S, Sayadjou S. Hospital based analysis of 204 cases of hysterectomies with evaluation of the route of surgery and complications rates. Southeast Asian J Case Rep Rev 2014;3(6): 1060–1066.
Practice C on G. Choosing the route of hysterectomy for benign disease. Obstet Gynecol 2017;129(6):1149–1150. DOI: https://doi.org/10.1097/AOG.0000000000002112.
Reich H, De Caprio J, Mc Glynn F. Laparoscopic hysterectomy. J Gynecol Surg 1989;5(2):213–216. DOI: https://doi.org/10.1089/gyn.1989.5.213.
Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing and Health 1990;13:227–236.
Mehta K, Prakash O, Fatehpuriya DS, et al. Comparative study of abdominal hysterectomy and vaginal hysterectomy in non-descent cases a prospective study. Int J Reprod Contracept Obstet Gynaecol 2017;6(4):1265–1270. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170952.
Patel R, Chakravarty N. Comparative study of laparoscopic hysterectomy versus vaginal hysterectomy Int J Med Sci Public Health 2014;3(3):335. DOI: 10.5455/ijmsph.2013.020120141.
Roy KK. A prospective study of TLH, LAVH and NDVH for the treatment of benign diseases of the uterus. Arch Gynecol Obstet 2011;284(4):907–912. DOI: 10.1007/s00404-010-1778-5.
Konar H, Sarkar M, Dessa D. Deciding the appropriate route and method of hysterectomy for women with benign diseases: A cross-sectional study at a tertiary care hospital, India. J Clin Diagn Res 2021;15(6):QC09–QC12. DOI: https://doi.org/10.7860/JCDR/2021/46693.15018.
Sarada Murali M, Khan A. A comparative study of non-descent vaginal hysterectomy and laparoscopic hysterectomy. J Obstet Gynecol India 2019;69(4):369–373. DOI: 10.1007/s13224-019- 01227-1.
Tondge G, Dasila PS, More N, et al. Comparison of intraoperative and postoperative outcomes of nondescent vaginal hysterectomy and total laparoscopic hysterectomy. MGM J Med Sci 2021;8(4):342–348. DOI: 10.4103/mgmj.mgmj_48_21.
Nimbannavar H, Chugh A, Rama A, et al. Comparative study of non-descent vaginal hysterectomy and total laparoscopic hysterectomy performed for benign gynaecological conditions. Int J Reprod Contracept Obstet Gynecol 2021;10(3):993–999. DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20210722.
Morton M, Cheung VY, Rosenthal DM. Total laparoscopic versus vaginal hysterectomy: A retrospective comparison. J Obstet Gynaecol Can 2008;30(11):1039–1044. DOI: 10.1016/S1701-2163(16)32999-1.
Oby Nagar D, Sharma A, Shankar V, et al. A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus. International Journal of Clinical Obstetrics and Gynaecology 2018;2(4):63–68. DOI: 10.33545/gynae.2018.v2.i4b.107.
