Laparoscopically assisted vaginal hysterectomy

The LAVH revolution beginning in the late 1980s is far from over. The overwhelming growth and, at times, overuse of the laparoscopic approach have waned somewhat as physicians reevaluate LAVH, adopt new techniques such as arterial embolization and myolysis, and rediscover old techniques such as uterine morcellation at vaginal hysterectomy. In addition, the cost of new procedures and instrumentation has come under intense scrutiny. As analysis of patient care moves from cost containment to improved outcomes, there will be renewed interest in minimally invasive approaches. The challenge to accumulate data, critically analyze each approach, and select the most appropriate procedure for each patient holds the greatest promise for improved patient satisfaction and outcomes.