Objective:Hysterectomy can be performed by abdominal, vaginal and laparoscopic method.The abdominal approach is still being used by most of surgeons as operation of choice but Laparoscopic method has many advantages like magnified view of the operating field and the observation of the pelvic organs in a more natural state, with less tissue handling as well as early post operative recovery.The aim of present study is to evaluate and compare the results of total Laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).

Material and methods:A retrospective case control study was carried out in the department of obstetrics and Gynecology in Pacific Institute of Medical Sciences, Udaipur, Rajasthan. Women of all ages, having benign disease with uterus size of less than 12 weeks were included in the study. A total of 60 files were reviewed, 30 for TAH and 30 for LH.

Results:Among the hysterectomy in the LH group, 8 cases (26.66%) were done by LAVH technique, 21 cases (70%) were done by TLH technique. One case (3.33%) in the same group was converted to TAH in view of dense adhesions.Mean operation time was longer in LH group (138.7±31.5 minutes) than TAH group (113.5±33.8 minutes). Mean hospitalization time was shorter for patients who undergone LH (3.1±0.9 days) than patients who undergone TAH (6.92 ± 1.1 days).The average estimated blood loss was found to be more in TAH (78.5±6.8 ml) than LH (64.6±5.7 ml).Neither of groups had intraoperative complications, 1 patient who had TLH and 2 patients who had TAH had postoperative fever. One case of TAH developed wound infection which was managed conservatively.

Conclusion:LH is safe and reliable alternative to open surgery in the management of benign gynecological diseases, with the advantage of less intraoperative blood loss, fast recovery and short hospital stay and significantly less amount of pain.