Laparoscopic supracervical hysterectomy compared with total abdominal hysterectomy

OBJECTIVE: To assess if laparoscopic supracervical hysterectomy (LSH) had any advantage over traditional total abdominal hysterectomy (TAH) carried out for benign conditions.

METHODS: This prospective case control study was carried out between June 2005 and October 2006 in the Obstetrics and Gynecology Department of Zagazig University Hospitals, Zagazig, Egypt. Twenty-eight women operated upon by LSH were compared to 56 women who had undergone TAH. Variables compared were patient's age, weight, preoperative diagnosis, number of previous laparotomies, operative time, intra/post-operative complications, blood loss, uterine weight, hospital stay, need for analgesia, and resumption of normal activity.

RESULTS: Patient's demographics were similar in both groups. The operative time was longer in the LSH group (93.7±5.7 versus 69.0±6.8 min, p=0.001). Other operative and post-operative parameters were similar except that LSH patients showed shorter hospital stay (1.7±0.5 versus 4.0±0.7 days), time to resume normal activity (20.8±2.6 versus 50.0±7.9 days) and lower dose of post-operative analgesia (141.7±62.4 versus 282.0±87.4mg diclofenac), (p=0.001).

CONCLUSION: Laparoscopic supra cervical hysterectomy is a safe procedure and should be considered, if hysterectomy will be carried out for a benign condition with healthy cervix. A further larger study is needed to confirm these findings.