Total laparoscopic hysterectomy in patients with previous abdominal surgery

To evaluate the effects of previous abdominal surgery on the feasibility and the safety of total laparoscopic hysterectomy (TLH). One hundred seventy-four consecutive patients who underwent TLH in private hospital between February 2008 and December 2009 were retrospectively reviewed. Surgical history, operation time, blood loss, transfusion, conversion to an open surgery, complications and hospital stay were assessed in each patient. The patients were classified into two groups; patients with or without a history of abdominal surgery. Group 1 included patients with a history of abdominal surgery (n = 44) and Group 2 included patients without a history (n = 130). The complication rate was 6.8% in patients with (Group 1) and 5.4% in patients without (Group 2) a history of abdominal surgery, respectively. No bladder, bowel, ureteral, or vascular injuries occurred in either group. Transfusion was required in one patient without a history of abdominal surgery (Group 2; 0.8%). Three patients with (Group 1; 6.8%) and two patients without (Group 2; 1.5%) a history of abdominal surgery were converted to laparotomy. No statistically significant difference was noted between the groups with respect to the complication and conversion rates. In our study, TLH can be performed successfully in patients with a history of abdominal surgery.