Follow-Up Study Comparing Open Hysterectomy of Expert Surgeon and Laparoscopic Approach (Learning Curve) of the Same Surgeon Publisher



Arab M¹ ; Mishra RK² ; Chowhan JS³ ; Ardebili SN⁴ ; Ghavami B⁵ ; Yousefi N⁴
Source: World Journal of Laparoscopic Surgery Published:2019

Abstract

Introduction: The goal of minimal access surgery is to minimize damage to the patient without impairment of immunity and the effect of treatment compared to traditional open surgical techniques. Laparoscopic hysterectomy requires more surgical skills and the learning curve is steep. The goal of this study is to compare hysterectomy in learning curve (including about 50 first surgeries) with open hysterectomy of the same surgeon, expert in open surgery, for complications, hospital stay duration, transfusion, operative time, and readmission. Materials and methods: In a prospective cohort study, patients undergoing hysterectomy at an academic medical center located in Tehran were randomly assigned into laparoscopic (in learning curve) and laparotomy groups from 2016 to 2018. Study cases data were recorded regarding complications, hospital stay, operative time, and blood transfusion. Results: There was no significant difference regarding intra-and postoperative transfusion, hospital stay duration, postoperative complications, and readmission in laparoscopy and laparotomy groups of hysterectomy. However, operative time was significantly different in laparoscopy and laparotomy subgroups of hysterectomy and longer in the laparoscopic group (277 minutes in laparoscopy vs 196 minutes in laparotomy). Conclusion: This study encourages starting laparoscopy method instead of open surgery, even in the setting of expert open surgeons, and even in the advanced (level 4) surgery such as hysterectomy. © The Author(s).