IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-7-7-16020 Original Research Paper Learning curve In Laparoscopic radical hysterectomy - is it really steep? A single institution experience Subbiah Shanmugam Dr. Dr. Syed Afroze Hussain Dr. July 2018 7 7 01 02 ABSTRACT

 Introduction: Radical hysterectomy with pelvic lymphadenectomy is the current gold standard treatment for early–stage cervical cancer. Total

laparoscopic radical hysterectomy has been proven to be safe and feasible. But there are only a few literatures available on the learning curve for
this procedure. We have reviewed literature, analysed and discussed the surgical & oncological safety, advantages and short term outcome of
laparoscopic radical hysterectomy.
Objective: Aim of our study is to analyse our learning curve in total laparoscopic radical hysterectomy and to assess the surgical & oncological
safety, advantages and short term outcome of laparoscopic radical hysterectomy
Materials And Methods: This is a retrospective study where medical records of patients who underwent laparoscopic radical hysterectomy at our
department between 2015 and 2016 were reviewed retrospectively. Forty four patients included in the study were divided into the first 22 cases
(phase I) and the second 22 cases (phase II). Disease and surgery related parameters were compared.
Results: There was a significant decrease in the mean operating time, conversion rate, complication rate, duration of hospital stay and time to
normal residual urine in the phase II of learning curve. Operating time and blood loss were significantly less for patients who underwent upfront
surgery than who received preoperative therapy
Conclusion: Although TLRH is a technically demanding procedure with steep learning curve, our early results are promising and comparable with
series in literature. Extensive experience in open radical hysterectomy and familiarity in pelvic anatomy have made our learning curve less steep,
making the procedure be performed with more ease and with less complications after the initial few surgeries. With increasing experience and
appropriate patient selection, TLRH can be safely performed without compromising the oncological safety with all the advantages of minimal
access surgery