Comparison of two different laparoscopic hysterectomies: laparoscopic hysterectomy vs. total laparoscopic hysterectomy.

OBJECTIVE The aim of this study was to compare the efficacy and safety of laparoscopic hysterectomy (LH) and Total Laparoscopic Hysterectomy (TLH). METHODS Both types of hysterectomy were performed by retroperitoneal uterine artery sealing using LigaSure™ by four-puncture. A total of 45 patients were operated on by LH and 22 by TLH. The mean operation time, amount of intraoperative bleeding, drop in hemoglobin concentration, weight of removed uterus, major and minor per-post operative complications, and rate of conversion to the classical abdominal approach in the two groups were compared. RESULTS The mean operation time in TLH (110 min.) was significantly longer than in LH (65 min.). This was mainly due to the shorter mean operating time in the vaginal part of LH group (13 min.) compared to laparoscopic dissection of uterosacral ligaments and vaginal suturing (42 min.) in the TLH group. Median blood loss was also significantly higher in the TLH group (278 ml.) compared to the LH group (110 ml.). There were no significant differences in the mean drop of hemoglobin concentration, uterine weight, major and minor complications and conversion to laparotomy between the groups. CONCLUSION LH seems to be a faster and more demanding method than TLH. With its shorter operation time and less bleeding, LH may be preferred to TLH.