Aims and objectives:This study aimed to compare total laparoscopic hysterectomy (TLH) and non-descent vaginal hysterectomy (NDVH) with respect to patient demographics, surgical indications, operative parameters (uterine weight, duration of surgery, blood loss, hemoglobin change), hospital stay, perioperative complications, postoperative pain, cost factors, and learning curve.Materials and methods: This prospective observational study included 20 women fulfilling predefined inclusion and exclusion criteria.Participants were randomized into two groups: TLH (n = 10) and NDVH (n = 10).All patients underwent preoperative anesthetic evaluation and were followed up postoperatively for 6-12 weeks.Statistical analysis was performed using SPSS Version 29, with p < 0.05 considered statistically significant.Results: Two patients in the NDVH group were lost to follow-up; hence, the final analysis included 10 TLH and 8 NDVH cases.Baseline demographic and clinical characteristics were comparable between groups.Abnormal uterine bleeding was the most common indication for surgery.The duration of surgery was significantly longer in the TLH group, whereas NDVH demonstrated advantages in terms of operative time, cost, and learning curve.Total laparoscopic hysterectomy was associated with a shorter hospital stay.Perioperative complications were comparable between groups. Conclusion:Both TLH and NDVH are safe and effective surgical approaches for benign uterine conditions in non-prolapsed uteri.Non-descent vaginal hysterectomy offers the benefits of shorter operative time, cost-effectiveness, and ease of learning, while TLH provides the advantages of reduced postoperative pain and shorter hospital stay.Surgical route selection should be individualized based on the surgeon's expertise, patient preference, and institutional resources.
Roychoudhury et al. (Thu,) studied this question.