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Outpatient laparoscopic-assisted vaginal hysterectomy
D I Galen1, A Jacobson, L N Weckstein
1Bay Area Fertility Medical Group, Suite 4, 1855 San Miguel Drive, Walnut Creek, CA 94596, USA.
Study Objective:
To compare laparoscopic-assisted hysterectomy (LAVH) with conventional abdominal hysterectomy.
Design:
First 50 consecutive LAVH procedures.
Setting:
An outpatient facility at a major medical center (35 procedures) and a nonhospital free-standing surgicenter (15).
Patients:
Sequential sample of 50 women requiring hysterectomy.
Interventions:
LAVH in 46 women, converted to open laparotomy in 4.
Measurements And Main Results:
Outpatient LAVH was performed successfully in the majority of women. Most patients had significant uterine enlargement, pelvic adhesions, or endometriosis. Only six required replacement of autologous blood postoperatively. Other complications were cystotomy and postoperative pelvic hematoma in one patient each.
Conclusions:
LAVH can be performed safely in free-standing surgicenters. It offers several advantages to patients, and is considered cost effective by third-party payers.