Complications of laparoscopic total hysterectomy in patients of a high specialty hospital

Objective: Describe the intraoperative and postoperative complications in patients undergoing total laparoscopic hysterectomy (TLH). Method: Cases series carried out in the gynecology service of Hospital de Gineco-Obstetricia No. 3, Centro Medico Nacional La Raza, Institute Mexicano del Seguro Social, of all patients undergoing total laparoscopic hysterectomy from December 2015 to December 2018. Uterine weight, body mass index, age, comorbidities, CO2 use, and complications were documented. Frequencies, proportions, central tendency and dispersion measures were used. Results: 79 patients are reported. Mean age was 44.2 +/- 7.5 years. Surgery time was 104.3 +/- 32.7 minutes, and bleeding 102.8 +/- 62.3 mL. Six (7.6%) had intraoperative complications: two (2.5%) bladder injury, one (1.3%) bowel injury, one (1.3%) stump hemorrhage, and two (2.6%) where converted to exploratory laparotomy: one for uterine size > 14 cm, and one because malignant ovarian tumor was suspected. Seven patients (8.8%) had postoperative complications: four (5.1%) were re operated: 3 due to hemorrhage and 1 due to vaginal dome dehiscence; three (3.7%) had vaginal collection. Conclusions: The rate of perioperative complications reported in this series coincides with that reported in other studies. Surgery time and bleeding were slightly minors regardless of program's youth.