Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study

The present randomized study was undertaken in order to compare the short-t erm results between total laparoscopic hysterectomy and abdominal hysterect omy in a centre with experience in laparoscopic surgery, From January 1997 to September 1998 inclusive, 102 women aged 44-71 years were randomly assig ned to either total laparoscopic hysterectomy (n = 51 patients) or abdomina l hysterectomy (n = 51 patients). The patients' demographic characteristics were similar in both groups. Average intra-operative blood loss was lower in laparoscopic hysterectomy than in abdominal hysterectomy (P less than or equal to 0.001), The average time employed for laparoscopic hysterectomy w as 104.1 +/- 26.98 min; according to the learning curve experienced in this study, the range was 72-163 min and the results after the plateau was reac hed showed no statistical difference between laparoscopic and abdominal ope rating times, The mean length of hospital stay was 2.38 +/- 0.30 days in th e laparoscopic hysterectomy group versus 6.23 +/- 1.85 days in the abdomina l hysterectomy group (P less than or equal to 0.001). In conclusion, this s tudy shows that total laparoscopic hysterectomy can be effectively performe d within reasonable time limits, provided that operators are experienced su rgeons in operative laparoscopy and that operating times are comparable wit h those of abdominal hysterectomy.