Antoun Lina, Clark T Justin
Department of Gynaecology, Birmingham Women's NHS Foundation Trust, Birmingham, UK.
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Facts Views Vis Obgyn. 2025 Mar 28;17(1):75-83. doi: 10.52054/FVVO.2025.47.
Total laparoscopic hysterectomy (TLH) is associated with reduced post-operative pain and enhanced recovery, allowing same-day discharge (SDD). However, adoption of SDD TLH is not established, and practice varies.
To conduct a national survey of UK gynaecologists with an interest in laparoscopic surgery to obtain their views, opinions and experience of SDD TLH.
Members of the British Society for Gynaecological Endoscopy were invited to complete an online questionnaire between January 2023 and January 2024.
The questionnaire consisted of 16 questions about SDD TLH covering three domains: (i) service provision, (ii) prognostic variables and (iii) information giving and education.
One hundred and forty-eight clinicians from 148/215 NHS hospitals (69%) responded. One hundred and thirty one (89%) respondents thought that SDD following TLH was beneficial, and 48 (32%) hospitals had an established service. Adequate pain control was considered the most important factor to achieve SDD TLH, followed by control of nausea and vomiting. Seventy-eight (53%) respondents removed the urinary catheter at the end of the procedure. All respondents believed that managing patients' expectations was important to achieve compliance with SDD and 123 (83%) thought that developing an online preadmission patient information resource was needed.
One third of UK NHS hospitals have a SDD TLH service but there is variation in availability and protocols (pre-, peri- and post-operative management). These data can help develop health service strategy to promote SDD after TLH and standardise protocols.
WHAT IS NEW?: The survey quantifies and demonstrates hospital-level variation in uptake and practice of SDD provision after TLH.
全腹腔镜子宫切除术（TLH）与术后疼痛减轻及恢复加快相关，可实现当日出院（SDD）。然而，SDD TLH的应用尚未确立，且实践存在差异。
对英国对腹腔镜手术感兴趣的妇科医生进行全国性调查，以了解他们对SDD TLH的看法、意见和经验。
邀请英国妇科内镜学会成员在2023年1月至2024年1月期间完成一份在线问卷。
问卷包括16个关于SDD TLH的问题，涵盖三个领域：（i）服务提供，（ii）预后变量，（iii）信息提供与教育。
来自148/215家国民保健服务（NHS）医院的148名临床医生（69%）做出了回应。131名（89%）受访者认为TLH后的SDD有益，48家（32%）医院已建立相关服务。充分的疼痛控制被认为是实现SDD TLH的最重要因素，其次是控制恶心和呕吐。78名（53%）受访者在手术结束时拔除了导尿管。所有受访者都认为管理患者的期望对实现SDD的依从性很重要，123名（83%）受访者认为需要开发一个在线入院前患者信息资源。
英国三分之一的NHS医院提供SDD TLH服务，但在可及性和方案（术前、术中和术后管理）方面存在差异。这些数据有助于制定卫生服务策略，以促进TLH后的SDD并规范方案。
新发现是什么？：该调查量化并展示了TLH后SDD提供的采用情况和实践在医院层面的差异。
