Laparoscopically-assisted vaginal hysterectomy

A series of 153 consecutive patients is presented in whom a laparoscopically-assisted vaginal hysterectomy was planned and was performed in 147 of them (96%). Bipolar diathermy was utilized to diathermy the upper uterine pedicles above the uterine arteries. Neither the uterine arteries nor the uterosacral ligaments were ligated laparoscopically and the remainder of the hysterectomy was performed vaginally. In the other 6 patients in whom the operation was commenced laparoscopically, it was discontinued and the operation concluded vaginally in 1 patient and abdominally in the other 5 patients. The aim of using the laparoscopic technique has been to convert a potential abdominal hysterectomy into a vaginal hysterectomy. The technique and the results are discussed.