Cilj istraživanja: Usporediti vrijeme trajanja TLH s obzirom na iskustvo operacijskog tima u Klinici za ženske bolesti KBC Split. Materijali i metode: U istraživanje je uključeno 50 bolesnica koje su operirane metodom TLH u Klinici za ženske bolesti KBC Split. Skupinu I. činilo je 25 pacijentica koje su operirane na početku uvođenja tehnike, skupinu II. činilo je 25 pacijentica koje su operirane kad je to već bila rutinska operacija. Rezultati: U prvoj skupini ukupno trajanje operacije iznosilo je u prosjeku 121 min, dok je u drugoj skupini iznosilo 87min. Druga faza koja uključuje rezanje cervikovezikalnog mjehura i potiskivanje mjehura značajno je skraćena u drugoj skupini (p=0,027). U drugoj skupini rezanje sakrouterinih ligamenata je značajno skraćeno naspram prve skupine (p=0,013). Koagulacija i oslobađanje plicae latae skraćena je (p=0,225). Koaguliranje uterinih krvnih žila nije se bitno skratilo (p=0,468). Faza oslobađanja parametrija bitno se razlikovala u prvoj i drugoj skupini (p=0,0001). Kružno rezanje rodnice značajno je skraćeno u skupini II. (p=0,0009). Kao najdulju fazu u obje skupine identificirali smo šivanje rodnice (p=0,022). Zaključak: Koraci koji najviše utječu na skraćenje trajanja TLH su: koagulacija i rezanje sakrouterinih ligamenata s oslobađanjem peritoneuma, koagulacija i rezanje krvnih žila maternice, koagulacija i spuštanje lateralnih parametrija, rezanje rodnice te šivanje rodnice.

Objectives: To compare TLH surgery duration depending on surgical team experience during the introductory period of this technique in Ob Gyn ward, Clinical Hospital Center Split. Material and Methods: We introduced 50 patients from Ob Gyn ward, Clinical Hospital Center Split who underwent TLH for a variety of reasons. In order to highlight the difference the surgical team experience plays in duration of the surgery we compared the first 25 and the last 25 operations. Results: Average mean operating time for TLH was 121 min in the first group, and 87 min in the second group. The second step, cutting of cervico-vesical ligament and pushing the bladder is considerably shorter in the second group (p=0,027). In the second group time needed for cutting of uterosacral ligament is significantly reduced compared to the first group (p=0,013). IP ligament dissection wasn’t significantly shorter in second group (0,225). While the time needed for securing the uterine vessels averaged at 10min 17s in the second group it amounted to 8min 17s on average. Release of parametria varied considerably in the first and second group (p=0001). Circumferential vaginal dissection varied significantly between two groups (p=0,0009). As the longest stage in both groups we identified suturing the vagina. In the first group, this step lasted 30 min 13 s, while in the second group, the step lasted on average 15 min 11 s. Conclusion: The steps that are most affected by the shortening of the duration of TLH: coagulation and cutting of sacro-utherin ligaments peritoneum, coagulation and cutting the blood vessels of the uterus, coagulation and lower lateral parametria, cutting and suturing the vagina.