KUMJ | VOL. 16 | NO. 4 | ISSUE 64 | OCT.-DEC. 2018
Minimal Invasive Gynaecological Surgeries in Dhulikhel Hospital: One and Half Decade Long Experience
Tamrakar SR, Dongol A, Shakya S, Kayastha B
Abstract: Background
One of the greatest achievements in the surgical fields is the paradigm shift from
open surgery to minimal invasive surgery. Dhulikhel Hospital is one of the very few
institutions in Nepal where minimal invasive gynaecological surgeries are being
regularly performed since early years of its establishment. There are very few
publications related to experiences of minimal invasive gynaecological surgeries
published in Nepal.
Objective
To review the varieties of minimal invasive gynaecological surgeries and find out the
different milestones those were crossed in this field.
Method
This is retrospective study of minimal invasive gynaecological surgeries performed
from January 1, 2004 to June 30, 2018.
Result
A total of 1849 cases were performed by mid 2018. Almost half of the cases were
of Brahmin/Chhetri caste (49.9%). Mean age of the patients who underwent
gynaecological minimal invasive surgeries in DH was 36.70±10.60 years (with range
12-81 years). More than half of the patients were from Kavre (58.2%). Abnormal
uterine bleeding, ovarian lesions and chronic pelvic pain were the most common
indications for these procedures. Among these procedures, hysteroscopy (769 cases),
diagnostic laparoscopy with or without chromotubation (385 cases), operative
laparoscopy (419 cases) and LAVH/TLH (242 cases) were performed. In this study,
34 minimal invasive surgeries cases (1.8%) were converted to laparotomy for certain
reasons. Of them eight cases were of laparoscopic hysterectomies. Only very few
major and minor complications were experienced during this period.
Conclusion
Varieties of minimal invasive surgeries for various gynaecological problems were
performed with minimal complications. We scaled up these minimal invasive
surgeries over the period.
Keyword : Ectopic pregnancy, Fibroids, Hysteroscopy, Laparoscopy
