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Laparoscopically assisted vaginal hysterectomy

D A Johns1, M P Diamond

  • 1Harris Methodist Hospital, Fort Worth, Texas.

The Journal of Reproductive Medicine
|June 1, 1994
PubMed
Summary
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Laparoscopically Assisted Vaginal Hysterectomy (LAVH) is a viable option for gynecologic surgery, even in patients with contraindications to traditional vaginal hysterectomy. This review highlights its safety and efficacy in a cohort of 119 patients.

Area of Science:

  • Gynecologic Surgery
  • Minimally Invasive Procedures
  • Laparoscopy

Background:

  • The scope of gynecologic operations via laparoscopy has expanded to include hysterectomy.
  • Critical assessment of clinical outcomes and complications for these procedures is limited.

Purpose of the Study:

  • To retrospectively review the clinical outcomes and complications of 119 laparoscopically assisted vaginal hysterectomies (LAVHs).
  • To present a staging system for the laparoscopic portion of LAVH to aid in risk/benefit assessment.

Main Methods:

  • Retrospective review of 119 patients undergoing LAVH.
  • Analysis of indications, operative time, blood loss, hospitalization duration, and complications.
  • Development and application of a staging system for the laparoscopic component.

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Main Results:

  • Common indications included pelvic pain, menorrhagia, pelvic mass, and uterine myomas.
  • 79% of patients had contraindications for traditional vaginal hysterectomy.
  • Average operating time was 79 minutes, with average blood loss of 135 mL and hospitalization of 59 hours.
  • One intraoperative complication (bladder entry); 16 patients had blood loss >300 mL, none requiring transfusion.

Conclusions:

  • LAVH demonstrates potential advantages and a favorable safety profile, even in complex cases.
  • A proposed staging system can assist in evaluating the risk/benefit ratio of LAVH.
  • Further research is needed to establish the specific efficacy of LAVH compared to other hysterectomy methods.