Sibananda Nayak Meghana Raj RV



  The aim of the study is to know whether retroperitoneal method of total laparoscopic hysterectomy is better than conventional method of total laparoscopic hysterectomy. This was assessed by comparing both methods for intra-operative blood loss and urological complications.


An observational study was done in patients planned for total laparoscopic hysterectomy (TLH) for benign pathologies who gave their consent to be included in the study. Patients were divided into two groups based on method of surgery. Group 1 included patients who underwent conventional method of TLH while group 2 included patients who underwent retroperitoneal method of TLH. The data obtained from both the groups were compared and then analyzed for duration of surgery, blood loss and complications.


 Out of 102 patients, 71 underwent conventional method of TLH (group 1) and 31 underwent retroperitoneal method of TLH (group 2). The mean duration of surgery was 132.0 ±39.3 minutes  and 136.8 ±44.2 minutes in group 1 and group 2 respectively(p=0.643).The drop in haemoglobin level was 1.18 ±0.66g/dL and 1.11 ±0.45g/dL in group 1 and group 2 respectively (p=0.901). No significant complications were seen in both the groups (p=1.000).


There was no statistically significant difference between conventional method and retroperitoneal method of TLH in terms of blood loss and complications.




TLH, Retroperitoneal TLH, Complications of TLH, Uterine artery ligation in TLH, Ureteric injury

1. Baskett TF. Hysterectomy: Evolution and trends. Best Pract. Res. Clin. Obstet. Gynaecol. 2005;19(3 spec.iss.):295–305.
2. Flory N, Bissonnette F, Binik YM. Psychosocial effects of hysterectomy: Literature review. J Psychosom Res. 2005;59:117–29.
3. Matteson KA, Butts SF.Choosing the Route of Hysterectomy for Benign Disease. Obstet Gynaecol. 2017 Jun;129(6): 155-9.
4. Working group of ESGE. Surgical steps of total laparoscopic hysterectomy: Part 1: Benign disease by the European Society for Gynaecological Endoscopy (ESGE)1. Facts, views Vis ObGyn. 2019;11(2):103–10.
5. Jha S, Rowland S. Litigation in gynaecology. Obstet Gynaecol. 2014;16(1):51–7.
6. Adelman MR, Bardsley TR, Sharp HT. Urinary Tract Injuries in Laparoscopic Hysterectomy: A Systematic Review. J Minim Invasive Gynecol. 2014;21:558–66.
7. Arunadevi V. Hysterectomy : A clinicopathological corrrelation.Int J Cur Res Rev. 2015;7(10):51-4.
8. O’Hanlan KA, Huang GS, Garnier AC, Dibble SL, Reuland ML, Lopez L, et al. Total laparoscopic hysterectomy versus total abdominal hysterectomy: cohort review of patients with uterine neoplasia. JSLS. 2005;9(3):277–86.
9. Yeung PP, Bolden CR, Westreich D, Sobolewski C. Patient Preferences of Cosmesis for Abdominal Incisions in Gynecologic Surgery. J Minim Invasive Gynecol. 2013;20(1):79–84.
10. Radmila S, Gernot H, Milica B, Aleksandra G, Snežana B.Hysterectomy throughout history. Acta Chir Iugosl.2011;58(4):9-14
11. Chaudhry SR, Chaudhry K. Anatomy, Abdomen and Pelvis, Uterus Round Ligament. StatPearls Publishing. 2021
12. Kim TH, Kim TJ, Yoo HN, Lee YY, Choi CH, Lee JW, et al. Is laparoendoscopic single-site surgery (LESS) retroperitoneal hysterectomy feasible?: Surgical outcomes of the initial 27 cases. Taiwan J Obstet Gynecol. 2015 Apr 1;54(2):150–4.
13. Piscitelli JT, Simel DL, Addison WA. Obstet Gynecol. 1987;69(4):541-5
14. Sinha R, Sundaram M, Nikam YA, Hegde A, Mahajan C. Total Laparoscopic Hysterectomy with Earlier Uterine Artery Ligation. J Minim Invasive Gynecol. 2008;15(3):355–9.
15. Poojari VG, Bhat VV, Bhat R. Total Laparoscopic Hysterectomy with Prior Uterine Artery Ligation at Its Origin. Int J Reprod Med. 2014:1–4.
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