We aimed to study whether separating the vaginal and abdominal surgical fields during total laparoscopic hysterectomy (TLH) is associated with surgical site infection rates. This was a retrospective cohort study of all patients who underwent TLH and any concomitant procedures with two minimally invasive gynecologic surgery subspecialists between January 2016 and May 2023. Among 680 included patients, the rate of infection was 0.8% with surgical field separation and 1.3% without (3/377 vs 4/303; odds ratio 0.60, 95% CI, 0.13-2.70). There was no statistical difference between groups; however, the difference in infection rates between groups was extremely small, which led to inadequate power. Our findings suggest that rates of infection after TLH are low, with or without surgical field separation. Treating the vagina, perineum, and abdomen as a single, continuous operative field during TLH may be an acceptable practice.

中文翻译：

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全腹腔镜子宫切除术中的手术野分离。

我们的目的是研究在全腹腔镜子宫切除术（TLH）期间分离阴道和腹部手术区域是否与手术部位感染率相关。这是一项回顾性队列研究，研究对象为 2016 年 1 月至 2023 年 5 月期间在两名微创妇科手术专科医师处接受 TLH 和任何伴随手术的所有患者。在 680 名纳入的患者中，手术野分离的感染率为 0.8%，手术野分离的感染率为 1.3%。 （3/377 vs 4/303；比值比 0.60，95% CI，0.13-2.70）。组间无统计学差异；然而，组间感染率差异极小，导致动力不足。我们的研究结果表明，无论有或没有手术野分离，TLH 后的感染率都很低。在 TLH 期间将阴道、会阴和腹部视为单一、连续的手术区域可能是一种可接受的做法。