GYNECOLOGICAL LAPAROSCOPIC SURGERY: LEARNING CURVE

A study was conducted to review the learning curve of gynecological laparoscopic surgery from January 2012 to December 2014. Total 310 cases were included in the study. These patients had pelvic surgery including hysterectomy either total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy and Adenexal surgery (cystectomy, oophorectomy or adhesionolysis). After preoperative evaluation counseling and consent procedures were performed. Data was collected regarding patients profile variables, indications for surgery, intraoperative findings, intraoperative time, post operative recovery findings, analgesia requirements and discharge time from the hospital. Regarding the intraoperative time, comparison was made for duration of surgery in the 2012 and at the end of study period 2014. Results: Results of the study showed that there was no significant increase in complication either minor or major related to urinary tract or bowel injury. Operative time was decreased with time. Most common indication for hysterectomy was fibroid uterus or dysfunctional uterine bleeding. Most common indication for adenexal pelvic surgery was ovarian cyst and in most cases cystectomy was done. Patient recovery was smooth and post operative analgesia was much less as compared to the routine. Patient hospital stay was less as compared to the routine procedures for hysterectomy. It is concluded from the study that laparoscopic surgery is safe procedure with the clear advantages for the patient. With appropriate surgical training & skills, the surgical time is reduced. In the study complication rate, operating time was comparable to the already published studies. With proper training it is acceptable alternate to open abdominal procedures with clear advantages for the patient.