Previous Abdominal Surgery and Obesity Do Not Affect Outcomes of Total Laparoscopic Hysterectomy Adversely

Objective: The aim of this research was to assess the effects of previous abdominal surgery and obesity on the outcomes of total laparoscopic hysterectomy (TLH). Materials and Methods: In this retrospective cohort study, 234 women who underwent TLH for benign conditions between January 2011 and December 2016 in a university hospital were included. The study group consisted of patients who had at least 1 previous abdominal surgery and the control group had previous abdominal surgeries. In a further analysis, obese patients who underwent TLH were compared to obese patients who underwent total abdominal hysterectomy (TAH) during the same timeperiod. The main outcome parameters were duration of hospital stays and major complication rates. Results: The mean durations of hospital stays and major complication rates were similar between the patients with and without previous surgery (p = 0.372 and p = 0.099, respectively). The outcomes of 93 TLH and 146 TAH patients whose BMIs were >= 30 kg/m(2) were also compared. The mean BMIs of the TLH and TAH groups were 32.8 +/- 2.3 kg/m(2) and 33.0 +/- 2.7 kg/m2, respectively. The durations of hospital stays were significantly lower in the TLH group than in the TAH group (3.1 +/- 2.0 days versus 4.2 +/- 3.5 days; p = 0.006). There was a tendency for increased major complication rates in the TAH group, but this was not statistically significant. Conclusions: Having previous abdominal surgery does not seem to affect outcomes of TLH unfavorably. Laparoscopic surgery, rather than open surgery, shortens hospital stays of obese hysterectomy patients without unfavorable effects. Moreover, TLH is likely to be associated with lower major complication rates.