Total laparoscopic hysterectomy at the Aga Khan University Hospital, Nairobi.
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OBJECTIVE: To determine the outcomes of total laparoscopic hysterectomy at the Aga Khan University Hospital, Nairobi. To create awareness on the availability of the procedure and to recommend the procedure as a suitable option to total abdominal hysterectomy. DESIGN: A retrospective case analysis. SETTING: Private practice in a private hospital set up. SUBJECTS: One hundred and twelve laparoscopic hysterectomies were performed at the Aga Khan University Hospital, Nairobi. These cases have been reviewed, analysed and presented between May, 2000 and May, 2007. INTERVENTIONS: Total laparoscopic hysterectomies done. EXCLUSIONS: All cases performed at other hospitals in Nairobi and Mombasa, and all cases where the author was not the principal surgeon. RESULTS: The ages ranged from 36 to 74 years, the mean age being 48 years. The patients parity ranged from 0 to 9. Fifty seven point one percent of the patients presented with heavy prolonged periods with clots. Of all the cases performed 54.4% gave a history of a previous laparotomy or Caesarian section. The uterine size by clinical assessment ranged from bulky to 28 weeks. The operating times ranged from 25 to 240 minutes, scope in to scope out. The average hospital stay for patients undergoing total laparoscopic hysterectomies was 2.1 days. There were no intraoperative complications encountered. The majority of the uteri weighed between 101-300 g (50.8%). CONCLUSIONS: Laparoscopic surgery is now well accepted by specialists and patients. Where facilities allow advocating total laparoscopic hysterectomy for benign uterine pathology can be considered as a suitable option to abdominal hysterectomy.