Total laparoscopic hysterectomy: the Brisbane learning curve.
BACKGROUND
Total laparoscopic hysterectomy (TLH) is becoming more commonly used for gynaecological malignancies.


OBJECTIVE
To describe our experience with TLH since its introduction to our tertiary referral centre for gynaecological cancer in 2003.


METHODS
Retrospective analysis of the first 120 consecutive cases of TLH performed at our gynaecological cancer centre. Patients were divided into the first, second and third group of 40 patients. Operating time, estimated blood loss, hospital stay, conversion to laparotomy and intra- and postoperative morbidity were evaluated.


RESULTS
The three groups were similar with regard to baseline characteristics. For the entire group the mean hospital stay was 2.4 +/- 1.4 days and eight of 120 patients (6.6%) required conversion to laparotomy. Operating time, estimated blood loss and intraoperative morbidity were similar among the three groups. Postoperative morbidity was highest (25%) in the middle one-third of the patients (P = 0.022). The percentage of pelvic lymph node dissections increased from 2.5% in the first one-third of patients to 27.5% in the final one-third of patients (P = 0.003).


CONCLUSIONS
TLH can be established safely in a tertiary gynaecological cancer referral centre.
Garrett
Andrea J
AJ
Queensland Centre for Gynaecological Cancer, Royal Women's and Brisbane Hospital, Brisbane, Queensland, Australia.
Nascimento
Marcelo Carraro
MC
Nicklin
James L
JL
Perrin
Lewis C
LC
Obermair
Andreas
A
D000328:Adult; D000368:Aged; D001315:Australia; D002983:Clinical Competence; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome