Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy

BackgroundHysterectomy is a common major gynecological surgery. Total laparoscopic hysterectomy (TLH) has become a preferred method over traditional approaches due to its minimally invasive nature and reduced postoperative complications.AimThis study aimed to compare conventional total laparoscopic...

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Main Authors: Ahmed El-Minawi, Hossam El-shenoufy, Ahmed Hussein, Hesham El-fazary, Mostafa M. Bahaa, Alaa A. Alsharif, Hayam Ali AlRasheed, Mostafa Eldardiry
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1577904/full
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author Ahmed El-Minawi
Hossam El-shenoufy
Ahmed Hussein
Hesham El-fazary
Mostafa M. Bahaa
Alaa A. Alsharif
Hayam Ali AlRasheed
Mostafa Eldardiry
author_facet Ahmed El-Minawi
Hossam El-shenoufy
Ahmed Hussein
Hesham El-fazary
Mostafa M. Bahaa
Alaa A. Alsharif
Hayam Ali AlRasheed
Mostafa Eldardiry
author_sort Ahmed El-Minawi
collection DOAJ
description BackgroundHysterectomy is a common major gynecological surgery. Total laparoscopic hysterectomy (TLH) has become a preferred method over traditional approaches due to its minimally invasive nature and reduced postoperative complications.AimThis study aimed to compare conventional total laparoscopic hysterectomy (CTLH) with TLH involving bilateral uterine artery ligation (BUAL) at its origin, specifically evaluating blood loss and perioperative outcomes.MethodsIn this prospective randomized study conducted at Cairo University Hospital, 60 female patients undergoing TLH for benign uterine conditions were randomized. Group 1 (BUAL) involved bilateral uterine artery ligation at its origin, and Group 2 (CTLH) followed conventional TLH techniques. Preoperative assessments included comprehensive history, physical examinations, and relevant laboratory tests. Outcomes measured were intraoperative blood loss, operative time (from insufflation to skin suturing), intraoperative and postoperative complications, postoperative analgesic needs, and hospital stay.ResultsBoth groups were demographically similar. The BUAL group experienced significantly lower blood loss (103.7 ± 23.27 mL) compared to the CTLH group (128.7 ± 42.57 mL) (p < 0.05). However, the mean operative time was slightly longer in the BUAL group (169.33 ± 15.85 min) than in the CTLH group (160.50 ± 19.75 min). No major surgical complications or blood transfusions were reported in either group. The posterior approach to uterine artery ligation in the BUAL group was more time-efficient.ConclusionSecuring the uterine arteries at their origin during TLH reduces blood loss and provides a feasible alternative to conventional methods, despite a slightly longer operative time. Enhanced surgical expertise correlates with reduced operative duration and improved outcomes.
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spelling doaj-art-b6b63d3ffef74e3b8fcdc5feb163ead32025-08-20T02:13:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15779041577904Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomyAhmed El-Minawi0Hossam El-shenoufy1Ahmed Hussein2Hesham El-fazary3Mostafa M. Bahaa4Alaa A. Alsharif5Hayam Ali AlRasheed6Mostafa Eldardiry7Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, EgyptDepartment of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, EgyptDepartment of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, EgyptDepartment of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, EgyptPharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, EgyptDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Addulrahman University, Riyadh, Saudi ArabiaDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Addulrahman University, Riyadh, Saudi ArabiaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Kafr Alsheikh University, Kafr el-Sheikh, EgyptBackgroundHysterectomy is a common major gynecological surgery. Total laparoscopic hysterectomy (TLH) has become a preferred method over traditional approaches due to its minimally invasive nature and reduced postoperative complications.AimThis study aimed to compare conventional total laparoscopic hysterectomy (CTLH) with TLH involving bilateral uterine artery ligation (BUAL) at its origin, specifically evaluating blood loss and perioperative outcomes.MethodsIn this prospective randomized study conducted at Cairo University Hospital, 60 female patients undergoing TLH for benign uterine conditions were randomized. Group 1 (BUAL) involved bilateral uterine artery ligation at its origin, and Group 2 (CTLH) followed conventional TLH techniques. Preoperative assessments included comprehensive history, physical examinations, and relevant laboratory tests. Outcomes measured were intraoperative blood loss, operative time (from insufflation to skin suturing), intraoperative and postoperative complications, postoperative analgesic needs, and hospital stay.ResultsBoth groups were demographically similar. The BUAL group experienced significantly lower blood loss (103.7 ± 23.27 mL) compared to the CTLH group (128.7 ± 42.57 mL) (p < 0.05). However, the mean operative time was slightly longer in the BUAL group (169.33 ± 15.85 min) than in the CTLH group (160.50 ± 19.75 min). No major surgical complications or blood transfusions were reported in either group. The posterior approach to uterine artery ligation in the BUAL group was more time-efficient.ConclusionSecuring the uterine arteries at their origin during TLH reduces blood loss and provides a feasible alternative to conventional methods, despite a slightly longer operative time. Enhanced surgical expertise correlates with reduced operative duration and improved outcomes.https://www.frontiersin.org/articles/10.3389/fmed.2025.1577904/fulltotal laparoscopic hysterectomyuterine artery ligationblood lossoperative timesurgical complicationspostoperative recovery
spellingShingle Ahmed El-Minawi
Hossam El-shenoufy
Ahmed Hussein
Hesham El-fazary
Mostafa M. Bahaa
Alaa A. Alsharif
Hayam Ali AlRasheed
Mostafa Eldardiry
Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
Frontiers in Medicine
total laparoscopic hysterectomy
uterine artery ligation
blood loss
operative time
surgical complications
postoperative recovery
title Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
title_full Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
title_fullStr Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
title_full_unstemmed Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
title_short Effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
title_sort effect of bilateral uterine artery ligation on blood loss during total laparoscopic hysterectomy
topic total laparoscopic hysterectomy
uterine artery ligation
blood loss
operative time
surgical complications
postoperative recovery
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1577904/full
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