Total Laparoscopic Hysterectomy with Uterine Artery Clipping Vs. Conventional Laparoscopic Hysterectomy: A Randomized Controlled Trial

Background & Objective: Total Laparoscopic Hysterectomy (TLH) is a widely used minimally invasive approach for hysterectomy. Preoperative uterine artery clipping has been proposed to reduce blood loss and surgical complications, but its clinical utility remains uncertain. The present study was conducted with aim to compare the conventional laparoscopic hysterectomy vs. Total Laparoscopic Hysterectomy (TLH) with preoperative uterine artery clipping.Materials & Methods: This randomized controlled trial included 42 women undergoing TLH at Ain Shams University Maternity Hospital. Participants were randomly allocated to either the study group (Uterine artery clipping prior to TLH) or the control group (conventional TLH). The assessed outcomes included Estimated Blood Loss (EBL), operative time, hemoglobin changes, intraoperative complications, and hospital stay. Data was analyzed using SPSS software (version 23.0). P<0.05 was considered significant.Results: There were no significant differences between the two groups in baseline characteristics. Mean EBL was lower in the study group (130.75±113.69 ml) compared to the control group (173.86±119.32 ml), but the difference was not statistically significant (P=0.238). The mean operative time was significantly longer in the study group (72.76±7.05 min) than in the control group (63.76±6.28 min) (P<0.001). No significant differences were found in hemoglobin levels postoperatively, intraoperative complications, or hospital stay.Conclusion: A longer operating time was the consequence of TLH with preoperative uterine artery cutting, but there were no further advantages in terms of blood loss or other outcomes.