Our Summary

This research paper compares two surgical methods for removing the uterus for non-cancerous reasons: vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH). The aim was to see which procedure had more complications and which one had better results.

The researchers looked at studies that were done after 2000 and were randomly controlled trials, meaning the patients were randomly assigned to either the VH or LH group. They looked at things like how many complications there were, how long the surgery took, how much blood was lost, whether the surgery had to be changed mid-procedure, how much pain the patient was in after surgery, how long the patient stayed in the hospital, and how long it took for the patient to recover.

They found that both methods were about the same in terms of complications, whether the surgery had to be changed mid-procedure, pain on the day of surgery and two days after, how long the patient stayed in the hospital, and recovery time. However, the VH was quicker and caused less pain 24 hours after surgery than the LH.

So, when either method can be used, the researchers recommend the VH.

FAQs

  1. What were the primary and secondary outcomes of the study comparing vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH)?
  2. According to the study, which surgical approach should be the preferred choice for benign hysterectomy when both are feasible?
  3. What were the results of the meta-analysis in terms of overall complications, intraoperative conversion, postoperative pain, length of hospital stay, and recuperation time between VH and LH?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hysterectomy is to discuss with their healthcare provider the potential benefits and risks of both laparoscopic and vaginal hysterectomy for their specific situation. While both procedures are effective, it is important to consider factors such as operating time, postoperative pain, and length of hospital stay when making a decision. Ultimately, the choice between the two approaches should be based on individual patient factors and preferences.

Suitable For

Patients who are typically recommended for laparoscopic hysterectomy include those with benign gynaecological indications such as fibroids, endometriosis, adenomyosis, and abnormal uterine bleeding. These patients should be in good overall health and have a uterus of a size that is suitable for laparoscopic removal. Additionally, patients who are looking for a minimally invasive surgical approach with faster recovery times and less postoperative pain may also be good candidates for laparoscopic hysterectomy.

Timeline

Before laparoscopic hysterectomy:

  • Patient will meet with their gynecologist to discuss the need for a hysterectomy and the various surgical options available
  • Patient may undergo preoperative testing such as blood work and imaging
  • Patient will receive instructions on how to prepare for surgery, including fasting and discontinuing certain medications
  • Patient will undergo the laparoscopic hysterectomy procedure under general anesthesia
  • Recovery period in the hospital typically lasts 1-2 days
  • Patient may experience pain, bloating, and fatigue during the initial recovery period
  • Follow-up appointments will be scheduled to monitor healing and address any concerns

After laparoscopic hysterectomy:

  • Patient will continue to recover at home, following postoperative care instructions provided by their healthcare provider
  • Patient may experience some discomfort, fatigue, and spotting in the weeks following surgery
  • Patient will gradually resume normal activities and may be advised to avoid heavy lifting and strenuous exercise for a period of time
  • Follow-up appointments will be scheduled to monitor healing and address any concerns
  • Patient may experience improvements in symptoms that led to the hysterectomy, such as pelvic pain or heavy menstrual bleeding
  • Patient may need to adjust to changes in hormone levels and discuss any concerns with their healthcare provider.

What to Ask Your Doctor

  1. What are the potential complications associated with a laparoscopic hysterectomy compared to other surgical approaches?
  2. How long is the typical recovery time after a laparoscopic hysterectomy?
  3. What is the expected level of postoperative pain and how is it usually managed?
  4. How long will I need to stay in the hospital after a laparoscopic hysterectomy?
  5. Are there any specific factors that would make me a better candidate for a laparoscopic hysterectomy compared to other surgical options?
  6. How experienced are you in performing laparoscopic hysterectomies?
  7. What is the success rate of laparoscopic hysterectomies in treating my specific condition?
  8. Are there any long-term effects or risks associated with a laparoscopic hysterectomy that I should be aware of?
  9. Will I need any special follow-up care or monitoring after the procedure?
  10. Are there any alternative treatments or procedures that I should consider before opting for a laparoscopic hysterectomy?

Reference

Authors: Lee SH, Oh SR, Cho YJ, Han M, Park JW, Kim SJ, Yun JH, Choe SY, Choi JS, Bae JW. Journal: BMC Womens Health. 2019 Jun 24;19(1):83. doi: 10.1186/s12905-019-0784-4. PMID: 31234852