Objective: The aim of the work is to investigate whether minilaparotomy hysterectomy for benign uterine lesions might be a reasonable alternative to laparoscopic hysterectomy in terms of operative and postoperative short-term outcomes.
Methods: 105 patients scheduled to undergo total hysterectomy for a benign uterine lesion were divided into 3 groups according to their selection of the method of intervention after counseling: Group A (35 patients) minilaparotomy hysterectomy using conventional sutures.Group B (35 patients) minilaparotomy hysterectomy using bipolar vessel sealing system (Ligasure).Group C (35 patients) laparoscopic hysterectomy using Ligasure.
Result(s): The operating time in Group A (84.7  9.9 minutes), group B (55.3  7.8 minutes), while group C ( 94.8  16 minutes).The duration until resumption of intestinal sounds in group C (12.3  2.5 hours) in comparison to group A (17.4  1.9 hours) and group B (16.5  1.76 hours). Blood loss in group B (99.1 ± 30.8 ml) ,group A (130.3 ± 54.4 ml) and group C (136.6 ± 6.6 ml). The longest hospital stay occurred in group A (31.8 ± 5.7 hours) versus groups B (20.7 ± 2.5 hours) and C (19.3 ± 6 hours). The highest pain score was observed in group A (5.2 ± 1.1) versus groups B (3.8 ± 1.6) and C (3.7 ± 1.2).There was no significant difference in the incidence of intraoperative or postoperative complications.
Conclusion(s): The use of ligasure bipolar vessel sealing system in minilaparotomy hysterectomy was associated with less operative time and intraoperative blood loss, while it was comparable to laparoscopic hysterectomy in hospital stay and postoperative pain scoring with low morbidity and a short hospital stay. It may be a suitable alternative to laparoscopic hysterectomy which is ideal in areas which lack high laparoscopic experience or facilities.