Abstract
Objective: To assess perioperative surgical outcomes of total laparoscopic hysterectomy (TLH) in benign gynecologic conditions.
Methodology: This prospective descriptive study was conducted at Lady Willingdon Hospital, Lahore, from January to June 2025. Of 459 gynecological surgeries done during this period, 103 (22.4%) TLH were performed for non-malignant indications and included consecutively. These benign conditions were preoperatively assessed through endometrial sampling and confirmed postoperatively by histopathological examination. Perioperative data, including operative time, need for supplementary procedures, requirement for blood transfusion, and incidence of complications, were recorded and analyzed using SPSS 26.
Results: Mean age of participants was 45.9±3.5 years, parity 4.8±1.4, and BMI 25.3±0.9 Kg/m². Adenomyosis was observed in 56 (54.4%), followed by abnormal uterine bleeding in 31 (30.1%) patients, and fibroids in 6 (5.8%) patients. Isolated TLH was performed in 93 (90.3%) patients, and additional procedures were required in 10 (9.7%) patients. Mean operative time was 49.7 minutes. Blood transfusion was required in only 1 (0.97%) patient. No major intra- and post-operative complications were observed. Most patients (85; 82.5%) were discharged within 24 hours of surgery.
Conclusion: TLH for benign gynecological conditions demonstrated a favorable safety and efficacy profile, characterized by a low complication rate, minimal need for blood transfusion, and early postoperative discharge in most patients. These findings demonstrate the feasibility and appropriateness of TLH in resource-limited settings, provided the procedure is performed by adequately trained and experienced surgeons.

Key words: Adenomyosis, Laparoscopy, Hysterectomy, Operative time.