Implementation of laparoscopic hysterectomy in a community hospital: initial results compared with abdominal hysterectomy

Objective To compare the morbidity associated with laparoscopic and abdominal hysterectomies in a community hospital. Method Retrospective chart review and matched analysis. Results Two (7.4%) of 27 women who had a laparoscopic hysterectomy had significant postoperative complications, one a vesicovaginal fistula, and one pneumonia and pelvic haematoma. Two (1.2%) of 170 women who had an abdominal hysterectomy died postoperatively, and one developed a vesicovaginal fistula. Overall comparison with abdominal hysterectomies showed significantly greater anaesthetic time (3.75 vs. 1.75 h), greater estimated blood loss (450 vs. 242 ml) and shorter hospitalization (3 vs. 4.7 days) associated with laparoscopic hysterectomies. Compared with an abdominal hysterectomy matched for age, parity, previous operations, patient weight, and uterine weight (17 cases), laparoscopic hysterectomies were associated with significantly less median analgesia use after discharge (0 vs. 4 days) and shorter median recovery time (4 vs. 6 weeks). Conclusions Compared with an abdominal procedure, recovery after laparoscopic hysterectomy is quicker, less painful and requires shorter hospitalization.