Surgical Morbidity of Total Laparoscopic Hysterectomy for Be
The postoperative complication rate following total laparoscopic hysterectomy (TLH) is about 7%. The study was published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

The objective was to estimate the rate of perioperative complications and to define risk factors of 30-day major (Clavien-Dindo ≥ 2) postoperative complications of total laparoscopic hysterectomy (TLH) for benign disease.

Data of consecutive patients who have undergone TLH for the pathologically confirmed benign disease have been analyzed. Perioperative surgical outcomes, the occurrence of postoperative complications, readmissions, and reoperations within 30 days from surgery were registered. Univariate and multivariable analyses were performed to determine the factors associated with major postoperative complications. Over the study period, 3090 patients were included in the study.

- Conversion to open surgery occurred in 54 cases. The mean operative time for TLH was 87.7 minutes while meaning estimated blood loss was 119.5 mL.

- Overall, postoperative complications were registered in 430 patients, and major events were observed in 208 of the cases.

- Same-hospital readmissions and reoperations within 30-day from surgery occurred in 78 and 28 patients, respectively.

- At multivariable analysis, endometriosis, the need for conversion to open surgery, and the occurrence of any intraoperative complication were found as independent risk factors for major postoperative complications.

Total hysterectomy performed via laparoscopy is associated with an acceptable major postoperative complications rate. A huge effort should be made to minimize the occurrence of intraoperative complications and the need for conversion to open surgery. Patients undergoing TLH for endometriosis should be counseled about the increased risk of major postoperative events.