Total Laparoscopic Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy: Our Institutional Experience

Purpose: To study the outcome, feasibility, morbidity and safety of total radical hysterectomy and bilateral pelvic lymphadenectomy at our institution. Method: A total of 50 patients of carcinoma cervix and endometrium according to International Federation of Gynecology and Obstetrics stage were studied. Various patients parameters, i.e. age, weight, BMI and stage of the disease, were noted. Intraoperatively mean operative time and mean blood loss was recorded. Postoperative parameters noted in the present study were lymph node yield, surgical margin and hospital stay. Patients were followed up for a period of 6 months. Results: Mean age of patients was 54.2 years (range 45–67 years). Thirty-eight patients had carcinoma cervix (24 patients had stage IB1 and 14 patients had stage IA2) and 12 patients were diagnosed to have endometrial carcinoma (eight patients had stage IB and four patients had stage II). Mean operative time recorded was 166 min (range 120–210 min) and average blood loss calculated was 212 ml (range 150–320 ml). These patients did not require any intraoperative blood transfusion. One patient developed colovaginal fistula which was managed later with another surgery. Surgical margins of the specimen were free from tumour infiltration for all patients, and median lymph node yield was 14 (range 10–21). Mean hospital stay was 3 days. All the patients were followed up for 6 months, and all of them were recurrence-free till last follow-up. Conclusion: Total laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy was found to be effective and safe without compromising oncologic outcome with minimal morbidity in the form of colovaginal fistula in one patient. © 2017, Association of Gynecologic Oncologists of India.