Converting potential abdominal hysterectomy to vaginal one: laparoscopic assisted vaginal hysterectomy.

Jyothi Shetty,Deeksha Pandey,Asha Shanbhag

doi:10.1155/2014/305614

Abstract

Background. The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy. Material and methods. A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise. Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06 + 31.97 min versus 135.25 + 31.72 min; P < 0.05). However, the mean blood loss in LAVH was 100 mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79 mL versus 340.00 + 119.86 mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups.

Highlights

The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, decreasing associated morbidity and hastening recovery
Rates of various complications with hysterectomy have been reported in the range of 0.5% to 43% [1]
A total of 48 women were enrolled in the study. Out of these only 37 could be included as two were found to have frozen pelvis, one had broad ligament fibroid, and four menopausal women were found to have cervix flushed with vagina

Summary

Introduction

The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, decreasing associated morbidity and hastening recovery. The mean blood loss in LAVH was 100 mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24 + 117.79 mL versus 340.00 + 119.86 mL; P < 0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. The term “hysterectomy” though means removal of uterus; in practice it has a much wider classification depending upon the indication At times, it is done without removal of the cervix (supracervical hysterectomy) or with removal of adnexa (hysterectomy with salpingooophorectomy). Rates of various complications with hysterectomy have been reported in the range of 0.5% to 43% [1]

Objectives

Methods

Results

Conclusion