Laparoscopic versus Abdominal Hysterectomy for Benign Gynecologic Disease: A Systematic Review

Abstract

Introduction: Hysterectomy is one of the most common surgical procedures in gynecology. This review compares the outcomes of the total laparoscopic hysterectomy (TLH) versus the traditional total abdominal hysterectomy (TAH) for benign indications.

Methods: A systematic search of RCTs was performed, comparing TLH to TAH. Primary outcomes were intra- and postoperative complications, length of hospital stay, and time to return to normal activities.

Results: The analysis of 25 RCTs showed that TLH was associated with significantly less blood loss, lower rates of wound infection, less postoperative pain, and a shorter hospital stay compared to TAH. Time to return to normal activities was also significantly shorter. Operative time was longer for TLH.

Discussion: The minimally invasive approach of TLH offers numerous short-term benefits that facilitate faster recovery. While technically more demanding, its superior recovery profile makes it the preferred approach when feasible.

Conclusion: Laparoscopic hysterectomy is superior to abdominal hysterectomy for benign disease, offering a faster and safer recovery.