IMPLEMENTATION OF LAPAROSCOPIC HYSTERECTOMY IN A COMMUNITY-HOSPITAL -INITIAL RESULTS COMPARED WITH ABDOMINAL HYSTERECTOMY

Objective To compare the morbidity associated with laparoscopic and ab dominal hysterectomies in a community hospital. Method Retrospective c hart review and matched analysis. Results Two (7.4%) of 27 women who h ad a laparoscopic hysterectomy had significant postoperative complicat ions, one a vesicovaginal fistula, and one pneumonia and pelvic haemat oma. Two (1.2%) of 170 women who had an abdominal hysterectomy died po stoperatively, and one developed a vesicovaginal fistula. Overall comp arison with abdominal hysterectomies showed significantly greater anae sthetic time (3.75 vs. 1.75 h), greater estimated blood loss (450 vs. 242 ml) and shorter hospitalization (3 vs. 4.7 days) associated with l aparoscopic hysterectomies. Compared with an abdominal hysterectomy ma tched for age, parity, previous operations, patient weight, and uterin e weight (17 cases), laparoscopic hysterectomies were associated with significantly less median analgesia use after discharge (0 vs. 4 days) and shorter median recovery time (4 vs. 6 weeks). Conclusions Compare d with an abdominal procedure, recovery after laparoscopic hysterectom y is quicker, less painful and requires shorter hospitalization.