Laparoscopic-assisted Doderlein hysterectomy: retrospective analysis of 300 consecutive cases

Objective To assess the clinical outcomes of the Doderlein laparoscopic-assisted hysterectomy. Design A retrospective study. Setting Women's Endoscopic Laser Foundation at South Cleveland Hospital, Middlesborough and St James's University Hospital, Leeds. Population Three hundred consecutive women who had a laparoscopic-assisted Doderlein hysterectomy. Methods Patients were identified from the laparoscopic hysterectomy theatre log at both sites. Case notes were requested and examined. Main outcome measures Operative time, uterine weight, associated pelvic pathology, blood loss, hospital stay, intra-operative and post-operative complications. Results The operations were performed by eight different surgeons, seven of whom were laparoscopic trainees. The mean operating time was 102 minutes (SD 30). Additional surgery including unilateral or bilateral salpingo-oophorectomy, was carried out in 247 patients (82%). The mean uterine weight was 140 g (SD 74). One hundred and thirty-two women (44%) had a normal pelvis at hysterectomy. The mean drop in haemoglobin and haematocrit was 1.46 g (SD 0.95) and 44% (SD 2.8), respectively. The overall complication rate was 18%, of which 6.2% were classed as major. The major complications included four cystotomies, five unscheduled laparotomies, seven post-operative blood transfusions, one pulmonary embolus and two re-operations (within six weeks). The mean hospital stay was three days. Conclusions Laparoscopic-assisted Doderlein hysterectomy is an alternative to standard laparoscopic hysterectomy techniques. It has the advantage of being easy to learn and is associated with low complication rates, compared with other laparoscopic and traditional techniques for hysterectomy.