Laparoscopically assisted vaginal hysterectomy compared with total abdominal hysterectomy (original) (raw)
Related papers
Journal of Gynecologic Surgery, 1994
The first 115 laparoscopically assisted vaginal hysterectomies (LAVH) done by our faculty surgeons were compared with 220 vaginal hysterectomies (VH) and 194 abdominal hysterectomies (AH) done in our affiliated hospitals over the same period of time. Logistic regression analysis indicates that LAVHs were done for cases that would significantly be more likely selected for AH than for VH (p < 0.0001). Matched case control studies with 28 LAVH/VH and 34 LAVH/AH pairs and bivariate analyses demonstrated that LAVH can be accomplished with low morbidity, short lengths of stay, and little, if any, increase in operating times compared with VH and AH. The LAVH procedure can be expected to replace many AHs in the future.
Minimally Invasive Surgery, 2014
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 d...
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1996
To assess the feasibility of performing laparoscopically assisted vaginal hysterectomy (LAVH) on women referred for total abdominal hysterectomy (TAH). Prospective intervention study on women referred for TAH from a gynaecological outpatient clinic. Groote Schuur Hospital, Cape Town. This institution accepts patient referrals from community hospitals and family physicians for hospitalised care. Forty-one consecutive women referred for TAH were suitable for LAVH. Women able to undergo conventional vaginal hysterectomy, women with uterine fibroids exceeding 14 weeks in size and subjects with malignant disease were excluded. The most common indication for hysterectomy was persistent abnormal bleeding. Of the 41 women assessed pre-operatively as suitable for LAVH, the procedure was successfully performed in 40 by means of a bipolar desiccation and scissors transection technique with re-usable equipment. Assessment of intra-operative and postoperative morbidity, surgical complications, o...
Comparison of Laparoscopically Assisted Vaginal Hysterectomy and Total Abdominal Hysterectomy
2008
Background: Hysterectomy is the second most common major surgery procedure done after cesarean section by gynecologists in many countries and the most common procedure is total abdominal hysterectomy (TAH). The incidence of laparoscopically assisted vaginal hysterectomy (LAVH) performed for benign lesions has progressively increased in recent years. Our objective was to compare the relative advantages and disadvantages of LAVH and TAH procedures. Methods: A clinical trial was performed on patients who were candidates for hysterectomy with benign reasons in Arash hospital from March 2006 to April 2007. By simple randomization, 90 patients (30 for LAVH and 60 for TAH) were selected. Demographic details and intra-operative and post-operative complications were recorded by the staff and were compared between the two groups. Results: On average, LAVH operations took significantly longer than TAH operations (100.17 ± 39.35 minutes; 145.83 ± 41.55 minutes; P< 0.0001). The total length o...
The Journal of the American Association of Gynecologic Laparoscopists, 2003
The American Association of Gynecologic Laparoscopists (AAGL) has been conducting membership surveys since 1976. Originally, surveys were designed to evaluate only sterilization techniques. As increasingly complicated operative laparoscopic operations became more widely accepted, it was apparent that laparoscopic-assisted vaginal hysterectomy (LAVH) was the most significant surgical procedure performed by most of the membership. Since 1989 the AAGL has actively attempted to document various aspects of LAVH through surveys of its members. The first survey in 1995 attempted to gain information as to current performance of the procedure and to assess relative frequencies and complications. Dr. Barbara S. Levy, who designed the 1995 survey with Drs. Jaroslav F. Hulka and William H. Parker, wrote this instrument, which was developed with few modifications from the earlier one to allow comparisons to be made between time periods. A total of 4437 surveys were mailed to AAGL members and contained 50 questions on laparoscopy, particularly LAVH, performed from January 1, 2000, to December 31, 2000. As in all AAGL surveys, the replies were strictly anonymous and confidential so that reporting of complications might be as frank as possible.
Outcomes and complications of laparoscopically assisted vaginal hysterectomy
International Journal of Gynecology & Obstetrics, 2006
Objective: To report whether operative time, intraoperative complications, and rate of conversion to laparotomy decreased after physicians had acquired an additional 4years experience with laparoscopically assisted vaginal hysterectomy (LAVH). Methods: Group 1 (n = 462) included the women who underwent LAVH from May 1, 1994 to December 31, 1997, and group 2 (n = 583) included those who underwent LAVH from January 1, 1998 to December 31, 2001. Results: The mean duration of surgery in groups 1 and 2 was 146 and 114 min, respectively, and the difference was significant ( P b 0.0001). The overall complication rate in the last 4years of the study was 7.1%, which was significantly lower than the 13.4% calculated for the first 4years ( P = 0.001). Conclusion: Operative time as well as rates of surgical complications and conversion to laparotomy decreased with increased surgeon experience at performing LAVH.
American Journal of Obstetrics and Gynecology, 1999
We compared operative time, length of hospital stay, postoperative recovery, return to work, and costs for women undergoing laparoscopically assisted vaginal hysterectomy or abdominal hysterectomy. STUDY DESIGN: A prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy (n = 24) versus abdominal hysterectomy (n = 24) was carried out in a tertiary care setting. The main outcome variables were operative time, length of hospital stay, and return to work. Secondary outcomes were postoperative pain and return to normal activity as determined by weekly visual analog scales and daily diary. Hospital costs were calculated.
Replacement of Abdominal Hysterectomy by the Laparovaginal Technique – Its Success and Limitations
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1994
The objective of this study was to study the effect of replacing of most abdominal hysterectomies with the laparovaginal technique. Three gynaecologists trained in advanced operative laparoscopy performed 160 laparovaginal, open and vaginal hysterectomies in 3 private hospitals in Melbourne. One hundred and twenty seven (79.4%) of hysterectomies were laparovaginal, 16 (10.0%) were open and 17 (10.7%) were vaginal. The distribution of technique was similar for the 3 surgeons. The high incidence of laparovaginal hysterectomy was partly due to the ability to remove uteri up to the size of a 16-week pregnancy, to divide severe pelvic adhesions and to perform recto-vaginal excisional surgery in severe endometriosis. Abdominal hysterectomy was preferred for patients with uteri larger than a 16-week pregnant size, tough intestinal adhesions, multiple pelvic pathology requiring prolonged surgery or with excessive obesity. The infrequent use of vaginal hysterectomy was related to the low occurrence of vaginal prolapse, the routine use of endometrial ablation for the treatment of menorrhagia resistant to drug therapy in uteri less than 10 cm, and the preference for laparoscopic rather than vaginal removal of the ovaries. The considered advantages of laparovaginal hysterectomy compared to abdominal hysterectomy were the reduced time in hospital and reduced convalescence. The cost of laparovaginal hysterectomy in the present study is $600-700 higher than abdominal hysterectomy. The cost may be reduced by decreased use of disposable equipment or by earlier discharge of patients from hospital. Gasless laparoscopy facilitating a combined abdominal and vaginal technique using 2 surgeons may further