Comparison of Laparoscopic and Laparotomic Total Hysterectomy in Terms of Patient Satisfaction and Cosmetic Outcomes

<b>Background/Objectives</b>: Hysterectomy is the most common gynecologic surgical procedure. While extensive research has been conducted on the advantages of laparoscopy, the gynecology literature lacks sufficient studies on scar-related outcomes, patient satisfaction, and cosmetic outcomes. In this regard, this study aimed to compare cosmetic outcomes and patient satisfaction between laparotomy and laparoscopic hysterectomy cases performed at our tertiary university hospital center. <b>Methods</b>: Patients who underwent hysterectomy for benign gynecologic reasons were included in the study. The study group consisted of patients who had surgery via the laparoscopic technique, while the control group comprised patients who had laparotomy through a transverse abdominal incision (Pfannenstiel). Postoperative scar areas, scar thickness, color, height, and pain scores were evaluated after the 12th postoperative month. A digital caliper was used to calculate the scar area. Scar satisfaction and general body perceptions were assessed using questionnaires. <b>Results</b>: The mean scar area was significantly lower in the study group (<i>p</i> = 0.003). The physician's scar assessments revealed no significant differences between the Manchester Scar Scale, POSAS Observer Scale, Vancouver Scar Scale, and SCAR Scale. The mean POSAS Patient Scale score, which assesses patients' opinions of postoperative scars, was significantly lower in the study group than in the control group. In contrast, the Body Image Questionnaire score was higher (<i>p</i> < 0.01). There were no significant differences between the groups in mean Rosenberg Self-Esteem Scale and Body-Cathexis Scale scores. <b>Conclusions</b>: The patients in the study group were more satisfied with their scars but less satisfied with their body image. Contrary to general expectations, the patients were found to be less satisfied with the visible scar outcomes on the abdominal wall resulting from multi-port surgical procedures. Studies are needed to inform patients about scars before operations, select ports for use during operations, and evaluate the effect of the port-site surgical repair technique on cosmetic outcomes.