Role of uterine artery occlusion at origin during total laparoscopic hysterectomy in non-malignant cases for optimal surgical outcome

OBJECTIVE: Total laparoscopic hysterectomy (TLH) offers faster recovery and less discomfort, but complex pelvic pathologies, adhesions, and scar tissue from prior conditions can complicate the procedure. This study compared the benefits of ligating the uterine arteries at their origin during a total laparoscopic hysterectomy to ligating the uterine arteries subsequent to the cornual pedicles. METHODS: A retrospective observational cohort was conducted from March 2022 to March 2024 to compare patients in the two groups pertaining to clinical and surgical outcome measures. The sampling technique used was purposive. Data extraction was accomplished from various databases in the hospital regarding demography and clinical profiles, indications for hysterectomy, and operative and postoperative details. STRATA 14.2 was used for statistical analysis. RESULTS: An aggregate of 141 patients underwent TLH over two years. Among them, 92 experienced conventional TLH (group B), while 49 received TLH with prior uterine artery occlusion at origin (group A). The operative time and hemorrhage were significantly lower in group A compared to group B (p < 0.001 in both identities). Group A also saw an elevated rate of patients with higher difficulty levels, specimens with larger volumes (p < 0.0001), and a lower complication rate (p = 0.029). CONCLUSION: The study demonstrated that occlusion of the uterine arteries at their origins is a safe and feasible approach. This step is cardinal during surgeries in challenging pelvic diseases posed by various pathologic and anatomical variations while offering less morbidity to the patient.