Total Laparoscopic Hysterectomy With Prior Uterine Artery Cauterization From the Origin Versus Conventional Laparoscopic Hysterectomy

The most common non-pregnancy-related gynecological procedure performed for women is a hysterectomy. (Uwais et al,. 2024 )In Germany, the incidence of hysterectomy ranges from 2.13 to 3.62/1000, while in the United States, it is 5.4/1000. In the US, about 600,000 hysterectomy surgeries are carried out each year. (Harvey et al ,. 2022 ) Fibroids, adenomyosis, endometriosis, dysfunctional uterine bleeding, uterine prolapse, and premalignant and malignant lesions are among the many indications for a hysterectomy. (Singh et al ,. 2024 ) Traditionally , hysterectomy has been done abdominally or by vaginal route . In the present era , Laparoscopic hysterectomy has recently received a considerable respect as a favourable hysterectomy technique . ( Bartels et al ,. 2020 ) Laparoscopic hysterectomy is a safe , workable technique , provides minimal post operative discomfort, shorter hospital stay , rapid convalescence , early return to daily activities. ( Pepin , K. et al ., 2020 ).

Selection of route of hysterectomy can be influenced by size , shape of the vagina and uterus, accessibility of the uterus, extent of extra uterine disease , surgeon experience, available hospital support, whether the case is emergent or scheduled and preference of the informed patient . ( Panda et al ,. 2022 )

.As Laparoscopic surgery becomes more advanced and widely applied, the absolute contraindications to laparoscopy are diminishing . Patient limitations to Laparoscopic surgery can be both anatomical and physiological .

Adverse anatomical limitations include difficult access to the abdomen , obliteration of the peritoneal space , organomegaly , intestinal distension and the potential for cancer dissemination.

The major physiological obstacles to safe Laparoscopy include increased intracranial pressure, abnormalities in cardiac output and gas exchange in the lung , chronic liver disease and coagulopathy . These anatomical and physiological conditions were formerly considered absolute contraindications to laparoscopy, they are now considered only relative contraindications.( Madhok et al ,. 2022 )