Related Experiment Videos
Introduction of laparoscopically assisted vaginal hysterectomy in a private teaching community hospital
P Bernstein1, P Fenton, K Walla
1Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Study Objective:
To compare laparoscopically assisted vaginal hysterectomy (LAVH) with traditional total abdominal hysterectomy (TAH) when the laparoscopic approach is introduced into a private hospital.
Design:
During 1 year, 49 LAVHs were performed and compared with 51 consecutive TAHs using retrospective chart review and statistical analysis.
Setting:
A private, university-affiliated, teaching hospital.
Patients:
All patients undergoing LAVH, and the first 51 TAHs performed during the study year.
Measurements And Main Results:
No major complications occurred in either group. Significant differences were observed in uterine weight (161 +/- 92 g vs 331 +/- 354 g), operating time (164 +/- 48 min vs 108 +/- 28 min), and hospital stay (2.93 +/- 1.21 days vs 4.00 +/- 1.54 days) for LAVH and TAH, respectively. Hospital charges for LAVH average $4074 more than for TAH, primarily due to the use of disposable laparoscopic equipment.
Conclusions:
Laparoscopically assisted vaginal hysterectomy may be performed safely in a private community hospital with appropriate surgeon credentialing and training. Modifying techniques to minimize the use of disposable equipment would make the procedure more cost effective.