Laparoscopic Hysterectomy for 2780 Patients: In Havana's National Center for Minimally Invasive Surgery

Objective: Hysterectomy is one of the most-common surgical procedures worldwide. Following cesarean section, hysterectomy is the second most-common gynecologic operation in women of reproductive age. Total laparoscopic hysterectomy (TLH) plays an important role in gynecologic surgery. The aim of this research was to assess the feasibility, safety, and long-term outcomes of TLH performed at the National Center for Minimally Invasive Surgery in Havana, Cuba. Materials and Methods: This was a retrospective study using a prospectively maintained database. Between January 1998 and December 2018, TLH was performed in 2780 patients in the department of laparoscopic and endoscopic surgery, at the Center. Results: The mean age of the patients was 47, and uterine fibroid was the most-frequent surgical indication. The median operative time and median blood loss were 90 minutes (range 30–240 minutes) and 100 mL (range: 20–400 mL), respectively. The median weight of the uteri was 290 g (range: 60–1200 g). Morbidity occurred in 4.7% of the cases, and 21 (0.7%) patients required conversion to laparotomy. Conclusions: TLH is a feasible and safe technique for treating benign and malignant diseases of the uteri and ovaries. In the opinion of the authors, whenever vascular pedicles can be treated safely, TLH is possible in uteri larger than 1000 g.