Comparative Study of Blood Loss in Total Laparoscopic Hysterectomy by Ligation the Uterine Arteries in Different Techniques.

Mostafa Bahaa

Status: Enrolling

Conditions: Gynecologic Disease

Treatments: Procedure: BTLH with bilateral uterine artery ligation from its origin; Procedure: Conventional TLH

Study type: Interventional

Funder types: Other

Identifiers

NCT06875518

8749

Details and patient eligibility

About

Following Caesarean section, hysterectomy is the second most common major gynecological surgery, with approximately 600,000 procedures performed annually in the USA. Since Reich et al. first reported a total laparoscopic hysterectomy (TLH) in 1989, numerous studies have confirmed its feasibility and reproducibility. Evidence increasingly supports TLH over vaginal hysterectomy (VH) and total abdominal hysterectomy (TAH) for benign gynecological conditions. The development and rapid advancement of laparoscopic instruments and techniques have enabled the safe and successful completion of complex procedures using minimally invasive approaches. Women with a higher BMI or requiring complex surgeries benefit from reduced postoperative complications with laparoscopic operations.

Enrollment: 60 estimated patients

Sex: Female

Ages: 35 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged between 35-60 years Patients presented with menometrorrhagia unresponsive to medical treatment, and uterine pathology such as adenomyosis or multiple fibroids.

Exclusion criteria

• Patients were excluded if they had: medical conditions preventing pneumo-peritoneum
• Patients with medical conditions hindering proper ventilation during general anesthesia.
• Patients diagnosed with endometrial carcinoma and patients with uterine size larger than 24 weeks were excluded.
• Patients with excessive adhesions precluding access to the uterine arteries were not enrolled in the study.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Control group

Active Comparator group

Description:

Group 1 (BTLH with bilateral uterine artery ligation from its origin): The round ligament close to the pelvic side wall is first coagulated and separated before the procedure is applied.

Treatment:

Procedure: BTLH with bilateral uterine artery ligation from its origin

Conventional TLH

Active Comparator group

Description:

The conventional TLH technique involved division of the corneal pedicles and securing the uterine pedicles. Preoperative Preparation of bowel wasn't routinely done to improve enhanced recovery of patients.

Treatment:

Procedure: Conventional TLH