Comparative evaluation of minilaparotomy hysterectomy versus conventional abdominal hysterectomy for benign gynecological conditions: A prospective comparative study

Background: Conventional abdominal hysterectomy remains widely used for benign gynecological conditions, particularly where minimally invasive surgical facilities are limited. However, its relatively large abdominal incision may be associated with greater blood loss, postoperative pain and delayed recovery. Minilaparotomy hysterectomy uses a smaller suprapubic incision while retaining the familiar steps of open abdominal surgery and may therefore provide a practical, less invasive alternative. Objective: To compare the feasibility, safety and perioperative outcomes of minilaparotomy hysterectomy with conventional abdominal hysterectomy in women with benign gynecological conditions. Materials and Methods: This prospective comparative study included 70 eligible women undergoing hysterectomy for benign gynecological conditions. Participants were divided equally into Group A, comprising 35 women who underwent minilaparotomy hysterectomy, and Group B, comprising 35 women who underwent conventional abdominal hysterectomy. Operative duration, estimated blood loss, transfusion requirement, postoperative analgesic use, ambulation, initiation of oral intake, duration of hospitalization and perioperative complications were compared. Quantitative variables were analyzed using the independent-samples t-test, while categorical variables were compared using the chi-square or Fisher’s exact test. A p value <0.05 was considered statistically significant. Results: Both procedures were completed successfully in all participants, and no major intraoperative complications were observed. Surgery was completed within 60 minutes in 82.9% of Group A patients compared with none in Group B (p <0.001). Mean intraoperative blood loss was significantly lower in Group A than in Group B (77.57 [24.23] versus 218.86 [67.20] mL; mean difference=-141.29 mL; p <0.001). No Group A patient experienced blood loss ?300 mL compared with 25.7% in Group B (p=0.001). Blood transfusion was required in 20.0% and 62.9% of patients, respectively (p <0.001). Only 8.6% of Group A required additional analgesia compared with 28.6% of Group B (p=0.031). Ambulation within 12 hours, oral intake within 10 hours and hospitalization of five days or less were recorded in 65.7%, 74.3% and 74.3% of Group A patients, respectively, but in none of Group B patients (all p <0.001). Wound infection (17.1% versus 14.3%; p=0.743) and wound resuturing (11.4% versus 2.9%; p=0.164) did not differ significantly between the groups. Conclusion: Minilaparotomy hysterectomy was a feasible and safe alternative to conventional abdominal hysterectomy in appropriately selected women. It was associated with shorter operative duration, less blood loss, fewer transfusions, lower analgesic requirements and faster postoperative recovery without an observed increase in major complications. It may provide a useful surgical option in settings where advanced minimally invasive facilities are unavailable.