Minimally Invasive Hysterectomy at a University Teaching Hospital

Abstract

Background and Objectives:To evaluate the feasibility of a minimally invasive approach for hysterectomy for benign disease at a university teaching hospital.Methods:Five hundred thirty-seven consecutive patients underwent hysterectomy for benign disease at Penn State Milton S. Hershey Medical Center in 2010. No cases were excluded. Minimally invasive approaches included total vaginal hysterectomy, laparoscopy-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and laparoscopic supracervical hysterectomy. All surgeries were completed with the resident as the primary surgeon or first assistant.Results:The median age was 45 years, the median body mass index was 30 kg/m2, the median estimated uterine size was 11 cm, and 22% of patients had a prior cesarean section. Of the 537 hysterectomies, 526 (98%) were started with a minimally invasive approach and 517 (96%) were completed in that fashion; thus only 9 conversions (2%) were required. Of the cases in which a minimally invasive approach was used, 16% were vaginal and 84% were laparoscopic. The median operative time was 86 minutes, the median blood loss was 95 mL, the median hospital stay was 1 day, and the median uterine weight was 199 g. For the minimally invasive hysterectomies, there was a 5% major complication rate.Conclusion:Our residency training institution completed 96% of 537 hysterectomies using a minimally invasive approach while maintaining an acceptable operative time, amount of blood loss, hospital stay, and complication rate. Thus our study supports that a minimally invasive approach for hysterectomy for benign disease at an academic resident teaching facility is feasible.

Does uterine manipulator type affect surgical outcomes of laparoscopic hysterectomy?

“…found the mean length of hospital stay 1 day. [ 32 ] The mean length of hospital stay was found 4.0 ± 0.6 days in the artUM group and 3.5 ± 1.1 days in the dUM group, but the difference was not statistically significant in our study ( P = 0.138 and P < 0.05).…”

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

“…Mitri et al . ( 26 ) reported on 434 patients who had undergone underwent hysterectomy for benign disease. He found that the median OT was 86 minutes, the median blood loss was 95 mL, and the median hospital stay was 1 day.…”

Uterine Fundectomy in Patients With Benign Etiology Undergoing Hysterectomy: New Surgical Technique

“…A variety of surgical techniques exists, including minimally invasive procedures (laparoscopic) and traditional open surgical procedures (laparotomy). Minimally invasive surgical procedures include laparoscopic hysterectomy and robotic-assisted laparoscopic hysterectomy [ 2 ]. Open surgical procedures include radical hysterectomy, where surgeons remove the uterus and surrounding tissues and cervix; a total hysterectomy, where the entire uterus and cervix are removed; and subtotal or partial hysterectomy, where the uterus is surgically removed but the cervix is left in place.…”