Design: This study follows a systematic review design based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

Setting: N/ A

Patients or Participants: Following registration in PROSPERO, the research includes thirteen studies describing female patients undergoing TLH for various medical reasons, such as uterine fibroids, abnormal bleeding, and pelvic organ prolapse. There are no restrictions based on demographic factors like age, race, or ethnicity. Article selection and data extraction was conducted by two independent reviewers, and the Newcastle-Ottawa Scale used to assess quality.

Interventions: N/A

Measurements and Main Results: Our electronic search identified 178 studies. After a rigorous process of reviewing, a total of 13 studies were included. The findings revealed significant variability in outcomes. For instance, estimated blood loss ranged from 32.2 to 256 mL, with power morcellation associated with greater blood loss compared to manual morcellation (164.7 ± 435.1 vs. 32.2 ± 27.6, respectively). Length of hospital stay varied from 1 to 4 days. Regarding bag integrity, while some studies reported no injuries, others documented cases of tissue spillage and bag tears during power morcellation. Additionally, morcellation times were variable, with manual morcellation being faster than power morcellation (9.6 ± 8.1 vs. 30.2 ± 22.4 minutes). Operative times also exhibited variability, ranging from 112.5 to 229.5 minutes, with no statistically significant difference between manual and power morcellation. Complications, categorized using the Clavien-Dindo classification, included ureter injuries, infections, and bladder injuries, with varying degrees of severity.

Conclusion: These findings have significant implications for clinical decision-making, safety protocol enhancements, and the potential development of guidelines to improve outcomes for patients undergoing TLH.