Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience at a Tertiary Care Hospital in North India.

Introduction Total laparoscopic hysterectomy (TLH) has emerged as a preferred surgical approach for managing various benign and premalignant gynecological conditions. It offers significant advantages over traditional hysterectomy techniques, including reduced blood loss, shorter hospital stays, and lower complication rates. However, its adoption varies across healthcare settings, with challenges such as a steep learning curve and technical difficulties in certain patient populations. This study presents a single surgeon's experience with TLH in a tertiary care center in North India, focusing on perioperative outcomes, complications, and surgical efficiency. Methods This retrospective observational study analyzed 150 patients who underwent TLH between January 2022 and December 2024. Data were collected from hospital records, including demographic details, surgical indications, intraoperative findings, perioperative outcomes, and complications. The surgical technique involved a standardized laparoscopic approach, with energy sources like LigaSure™ (Medtronic, Minneapolis, MN, USA) and harmonic probes. Statistical analysis included descriptive measures, with continuous variables presented as means and categorical variables as frequencies. Results The mean age of the patients was 50.04 ± 7.42 years, with a mean BMI of 27.77 ± 7.05. The most common indications for TLH were adenomyosis in 39 (26%), leiomyoma in 31 (20.67%), and combined leiomyoma with adenomyosis in 31 (20.67%). The mean operative time was 39 minutes, and the mean blood loss was 25 mL. Perioperative complications were minimal, with only one (0.67%) case each of ureteric stricture, bowel injury, bladder injury, and conversion to laparotomy. ICU admission was required in two (1.33%) cases, while postoperative urinary tract infections occurred in two (1.33%). The mean hospital stay was 2.09 days, and six (4%) patients required readmission. Conclusion This study highlights the safety, efficiency, and favorable perioperative outcomes of TLH in a tertiary care setting. The low complication rates, short hospital stays, and minimal blood loss reinforce TLH as a viable alternative to conventional hysterectomy methods. While the study benefits from a large sample size and single-surgeon consistency, its retrospective design and single-center scope are limitations. Future multi-center studies with long-term follow-up are recommended to validate these findings and explore the role of robotic-assisted hysterectomy in improving surgical outcomes.