Browsing by Author "Shrestha, Sabita"
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Publication Clinical Profile of Patients Undergoing Total Laparoscopic Hysterectomy(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Shrestha, Sabita; Dangal, Ganesh; Karki, Aruna; Pradhan, Hema Kumari; Shrestha, Ranjana; Bhattachan, Kabin; Sah, SadhanaAbstract: Introduction: Total laparoscopic hysterectomy (TLH) has emerged as a preferred alternative to abdominal hysterectomy for benign gynaecological conditions owing to its well-known benefits. With increasing use of laparoscopic techniques, it is important to evaluate the clinical profile and surgical outcomes of the patients undergoing total laparoscopic hysterectomy. Methods: This descriptive study was conducted at Kathmandu Model Hospital- Institute of Health Sciences over 5 months period after taking ethical approval. All patients undergoing TLH for benign indication were included in the study. Sociodemographic and clinical characteristics, operative details and immediate postoperative complications were recorded in a predesigned proforma. Data were analysed using SPSS version 20. P-value of <0.05 was considered statistically significant. Results: A total of 73 patients underwent TLH during the study period. The mean age and bod mass index was 46±5.83 years and 28.07±3.94 kg/m2 respectively. The most common presenting symptom was heavy menstrual bleeding (63%, n=46). Fibroid uterus (52.1%, n= 38) was the leading indication for TLH. The mean operative time was 149.04±40.33 minutes. A statistically significant association was observed between increasing uterine weight and longer operative time (p=0.001). The overall complication rate was 23.28% with no bowel or urinary tract injuries. Conclusion: Total laparoscopic hysterectomy is a safe and feasible options for benign gynaecological conditions, even in patients with higher body mass index and larger uterine size. Despite longer operative time, it has favourable perioperative outcome with acceptable complication rates.Publication Laparoscopic Suture Cervicopexy in Young Lady with Cervical Elongation(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Sah, Sadhana; Dangal, Ganesh; Karki, Aruna; Pradhan, Hema Kumari; Shrestha, Ranjana; Bhattachan, Kabin; Shrestha, SabitaAbstract: Cervical elongation with apical prolapse in young women poses a surgical challenge when uterine preservation in required. We report a case of 25-years female, P1L1, with symptomatic cervical elongation. She underwent laparoscopic suture cervicopexy with plication of round ligaments and uterosacral ligaments and moschcowitz procedure under general anaesthesia. This surgery had led to a good anatomical correction with satisfactory apical support and the uterus remained centrally positioned with resolution of prolapse symptoms.Publication Placenta Accreta Spectrum: A Case Report and Review of Diagnostic and Management Challenges(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Shrestha, Sabita; Ghimire, Nitesh; Dangal, Ganesh; Shrestha, Ranjana; Bhattachan, KabinAbstract: Placenta accreta spectrum (PAS) represent a major cause of severe obstetric hemorrhage and maternal morbidity, particularly in women with a history of cesarean delivery and placenta previa. Early antenatal diagnosis and multidisciplinary planning are essential to optimize outcomes. We report a case of placenta accreta spectrum with bladder involvement in a 33-year-old multigravida with a previous cesarean section, diagnosed antenatally by imaging. The patient underwent an emergency classical cesarean section followed by cesarean hysterectomy and bladder repair at 32 + 3 weeks’ gestation due to massive obstetric hemorrhage. Histopathological examination confirmed placenta accreta. This case highlights the importance accurate diagnosis and the need of multidisciplinary approach in a tertiary care center for the optimal outcome.