Indications, Surgical Details and Complications of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of the Initial 80 Cases

Introduction: Total laparoscopic hysterectomy (TLH) is a well-accepted mode of hysterectomy where the entire operation, including suturing of the vaginal vault, is performed laparoscopically. In this study, we evaluated the symptomatic indications, surgical details, and complications during and after surgery based on a single surgeon's experience.Methodology: This descriptive cross-sectional study was carried out with 80 patients who underwent TLH due to benign causes in teaching hospital Anuradhapura from September 2020 to October 2023 by using clinical data collected during the preoperative, intraoperative, and postoperative phases.Results: The most common symptomatic indications found in this study for TLH were secondary dysmenorrhea, heavy menstrual bleeding, and chronic pelvic pain. Adenomyosis and fibroids were the most common underlying pathologies for symptoms that led to hysterectomy. The average surgery time was 111.07 minutes, and significant positive correlations were found between surgery time and three variables: weight of the uterus (r = 0.358, N = 69, p=0.003), history of previous abdominal surgery (r = 0.328). N = 64, p=0.008) and existence of adhesions (r = 0.260, N = 69, p=0.031). There were no major complications, only minor complications were reported, and postoperative fever was the most common postoperative complication presented by the patients.Conclusion: Total laparoscopy has resulted minimal major post-surgery complications and the procedure was required for patients with adenomyosis and fibroids. The surgery time varies with the weight, existence of the adhesions and the history of abdominal surgeries