Hysterectomy is one of the most common surgery performed by Gynecologist. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus total laparoscopic hysterectomy and vaginal hysterectomy have gained popularity. Laparoscopic surgeries require high tech operation theatre setups, sophisticated instruments & high surgical skills. Vaginal hysterectomy descent or non descent is a simple and effective technique for benign pathologies of uterus.
Objective: This study was conducted to compare Total Laparoscopic Hysterectomy and Non Descent Vaginal Hysterectomy with reference to fall in blood haemoglobin level, duration of operation, weight of uterus, post operative complications and post-operative ambulation.
Materials and Methods: Patients undergoing both the types of hysterectomy i.e. TLH and NDVH during September 2017 to March 2018 at Mahila Chikitsalya Hospital (SMS Medical College) were included in the study. Those patients having malignancy as diagnosed by Pap smear or by D &C were excluded from the study. All the patients were investigated thoroughly for their cardio respiratory status, fitness for surgery and other medical conditions. Patients were observed vigilantly during the pre-operative, intra-operative and post-operative period for any complications.
Result: Thirty women underwent TLH, and thirty underwent NDVH. There was no statistically significant difference between groups in the mean age of patients, weight, BMI & literacy rates of patients of both the groups. TLH took significantly longer to perform; however, the estimated blood loss, mean postoperative hemoglobin change & the mean postoperative duration of hospital stay was greater in the VH group. Mean uterine mass was similar in both the groups. While there were no major intraoperative or postoperative complications; the incidence of minor complications were comparable in both the groups.
Conclusion: Maximum number of hysterectomies were done for adenomyosis (AUB A) and Fibroid uterus (AUB L). NDVH takes upper hand than TLH as it is more economic, takes lesser time, requires less surgical techniques in comparison to TLH. On the other hand TLH is associated with small scar of surgery, less morbidity and less post-operative pain. In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, technology available in the hospital and preference of patient as well as surgeon.