Background: The objective of this study was to compare clinical findings and inflammation indicator levels between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH) in an instructional setting.
Methods: In this prospective study, 80 total hysterectomy procedures were performed at the gynecology clinic of Imam Hossein Medical Center, Tehran, Iran over the period between January 2017 and October 2019. Patients were divided into two groups according to the type of operation. Forty patients underwent TLH (TLH group) and 40 patients underwent TAH (TAH group). Surgery-related outcomes and inflammatory mediators were both assessed before and 24 hours after the surgery.
 Results: We observed significantly lower operation bleeding (P <0.001), postoperative lower c-reactive protein (CRP) (P <0.001), higher length of surgery (P <0.001), and higher anesthesia duration (P <0.001) in TLH group compared to TAH group. There were no statistically significant difference between groups regarding post-operation transfusion, adverse events, polymorphonuclear leukocytes (PMN) count, white blood cell (WBCs) count  and platelet (PLT) count, as well as the homoglubin (Hb) levels.
Conclusion: Our study results show that the TLH can be safely performed in our instructional setting and it decreases intraoperative bleeding and postoperative day one CRP levels compared to the TAH method.