Total Laparoscopic Hysterectomy with Prior Uterine Artery Clipping versus Conventional Laparoscopic Hysterectomy: A Randomized Controlled Trial

Abstract Objective To compare the efficacy of total laparoscopic hysterectomy (TLH) with prior uterine artery clipping versus conventional laparoscopic hysterectomy Methods A randomized controlled study was conducted at Ain Shams University Maternity Hospital. The study included 42 women who were admitted from the general gynecology outpatient clinic and were planned to undergo TLH. Patients participating in the study were randomized into 2 groups; the control group, including women who were subjected to conventional TLH, and the study group, including women who were subjected to TLH with prior uterine artery clipping at its origin. Results The patient profiles in both groups were found to be similar, indicating a lack of confounding factors. No significant differences were observed between both groups in terms of age, BMI, parity, medical and surgical history, and the cause of hysterectomy. Regarding blood loss, no statistically significant difference was found between the two groups suggesting comparable outcomes in this aspect. However, a notable disparity was identified in terms of operative time. The study group had a mean operative time of 72.76±7.05 minutes, while the control group had a mean operative time of 63.76±6.28 minutes. This difference was highly statistically significant (p-value of < 0.001). All other outcomes (severe bleeding, post operative complications and operative time) were comparable between the two groups. Conclusion TLH with prior uterine artery clipping resulted in a longer operative time, without any added benefits regarding blood loss or other investigated outcomes.