Clinical Profile and Outcome of Patients Undergoing Total Laparoscopic Hysterectomy: A Prospective Study from a Secondary Care Hospital in Karachi

Abstract

Abstract: Background: The American Association of Gynecologic Laparoscopists recommends that numerous hysterectomies for non-cancerous conditions ought to be performed with laparoscopy. The patient's obstetric history significantly influences the outcomes. Information on the clinical profiles of patients receiving total laparoscopic hysterectomy (TLH) is rarely documented from Pakistan.

Objective: To present our experience of clinical profile of patients undergoing TLH in our secondary care institution at Koohi Goth hospital in Karachi.

Materials and Methods: The present prospective observational study was performed in Obstetrics & Gynecology Department in Koohi Goth Hospital from 1st August 2018 to 31st December 2023 after obtaining the institutional formal ethical approval (Ref: KGH/HR/134). All of the procedures were performed by single gynecologist having more than 5 years of experiences in performing laparoscopic hysterectomy. Information regarding patients’ demographics, clinical characteristics, procedure information and outcomes were documented.

Result: Total 100 cases were analyzed with mean age of 45 ± 7.8 years. Average BMI was 25.3 ± 8.1 Kg/m². Almost one-third of patients (32%) had history of previous surgery. The commonest surgical indication was uterine fibroids (54%), and while the least of post-menopausal bleeding. Average surgery duration was 124.26±44.74 minutes. Few patients developed complications (7%) including ureter injury (2%), wound infection (2%), vault infection (2%), and bladder injury (2%). All of complications were seen in either obese females or patients with history of previous surgery.

Conclusion: The present study found that minimally invasive TLH is a safe approach which is easily accessible and harmless for patients with minimal complication rate. Patients with previous history of surgery and elevated body mass index should be given additional care and attention to avoid complexity.