OBSERVATIONAL STUDY OF INTRAOPERATIVE AND EARLY POSTOPERATIVE COMPLICATIONS IN TOTAL LAPAROSCOPIC HYSTERECTOMY A PROSPECTIVE ANALYSIS OF 100 CASES

Abstract

Background: Total laparoscopic hysterectomy (TLH) is a minimally invasive alternative to abdominal hysterectomy,
offering benefits such as reduced postoperative pain, shorter hospital stay, and faster recovery. However, TLH is associated
with unique intraoperative and postoperative complications. Objective: To evaluate intraoperative and early
postoperative complications in patients undergoing TLH. Materials and Methods: This prospective observational
study included 100 consecutive patients who underwent TLH at a tertiary care center from September 2014 to August
2015. Data on patient demographics, operative time, intraoperative events, conversion rates, and complications within
24 hours post-surgery were systematically collected. Results: The mean age was 47.1 years, and mean BMI was 26.49
kg/m². Fibroids were the most common indication (48%). Mean operative time was 143.45 minutes, and mean hospital
stay was 2.8 days. One case required conversion to laparotomy due to dense adhesions. No intraoperative bladder,
bowel, or ureteral injuries occurred. Early postoperative complications were minimal: fever (1%), subcutaneous emphysema
(1%), hematoma (1%), and hemorrhage requiring transfusion (1%). Conclusion: TLH is a safe procedure
with low complication rates when performed by trained surgeons. Meticulous technique, preoperative planning, and
surgeon experience are key to minimizing risks, even in patients with high BMI or previous abdominal surgery.