Abdominal versus vaginal uterine bisection for retrieval of large uteri during laparoscopic hysterectomy

Heba R. Elbasuiny, Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt, Postal code: 31111
Ayman S. Dawood, Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt, Postal code: 31111Follow
Mohamed A. Raslan, Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt, Postal code: 31111

Article Type

Original Study

Subject Area

Obstetrics and Gynecology

Abstract

Objective To assess the operative time, blood loss, and safety of two retrieval techniques in large uteri during total laparoscopic hysterectomy. Methods A cohort multicenter study conducted at Tanta University Hospitals and private laparoscopy centers in Delta region, Egypt, from June 2021 till October 2023. In this study, 73 patients were enrolled in this study and allocated into either abdominal bisection (Group I) or vaginal bisection (Group II). Abdominal bisection is performed by endoknife, while vaginal bisection is made by scalpel. Uterine size, hysterectomy time, uterine retrieval time, blood loss, and complications were recorded and compared. Results The mean age, BMI, and parity were comparable in both groups. The most common indication for hysterectomy was myomas (40.9%). Hysterectomy time was 82.42 ± 16.08 minutes in Group I and 88.09 ± 17.13 minutes in Group II (p = 0.170). Uterine retrieval time was 31.51 ± 5.33 minutes and 30.27 ± 8.95 minutes in groups I and II, respectively (p = 0.496). Moreover, blood loss was not statistically significant in both groups (303.94 ± 92.52 ml versus 317.27 ± 126.37 ml in groups I and II, respectively; p = 0.952). Complications were minimal, either intraoperative or postoperative. Conclusion Vaginal bisection was associated with longer operative time, more blood loss, and more extended hospital stay, but these differences did not reach a clinical level of significance. We recommend vaginal bisection due to its safety.

IRB Number

34696/5/21

Keywords

Abdominal bisection; Vaginal bisection; Total laparoscopic hysterectomy; Operative time; Blood loss

Recommended Citation

Elbasuiny, Heba R.; Dawood, Ayman S.; and Raslan, Mohamed A. (2024) "Abdominal versus vaginal uterine bisection for retrieval of large uteri during laparoscopic hysterectomy," Journal of Medicine in Scientific Research: Vol. 8: Iss. 2, Article 6.
DOI: https://doi.org/10.59299/2537-0928.1432