Laparoscopic-assisted vaginal hysterectomy: A case control comparative study with abdominal hysterectomy

Abstract

A case control study of the operative time, blood loss, time for return to work, pain levels, and medications was conducted comparing laparoscopic-assisted vaginal hysterectomies (LAVH) with total abdominal hysterectomy (TAH). The average operating time for LAVH was 151 minutes whereas for TAH it was 99 minutes (P<.01). The average length of stay for the LAVH was 2.5 days and for the abdominal hysterectomy it was 3.5 days (P<.01). During hospitalization the LAVH group required an average of 180 mg of meperidine while the TAH group required 414 mg of meperidine (P<.01). Patients undergoing LAVH reported activity levels of 9.2 on a scale of 1 to 10, with 10 being unlimited activity, by day 14. Abdominal hysterectomy patients' activity was reported as only 6.4 on the same scale (P<.005). The LAVH group, although requiring more operating time, made a more rapid recovery, and less pain medication, and required shorter hospitalization than the TAH group.

Laparoscopic ovariectomy in dogs: a comparison of the LigaSure™ and the SonoSurg™ systems

“…Laparoscopic surgery is less invasive compared to conventional open surgery (Höglund and others 2010), and is associated with less postoperative pain (Davidson and others 2004, Devitt and others 2005, Hancock and others 2005) and increased postoperative activity counts when compared with an open technique (Culp and others 2009). In human beings, laparoscopic hysterectomy is found to reduce blood loss, postoperative pain, and duration of hospitalisation and recovery times when compared to open surgery (Carter and others 1994, Elia and others 1995, Sadik and others 1995, Gyr and others 2001). In dogs, laparoscopic ovariectomy or ovariohysterectomy has been performed using several methods, for example monopolar and bipolar electrocoagulation (Van Goethem and others 2003, Van Nimwegen and others 2005, Van Nimwegen and Kirpensteijn 2007), surgical laser (Van Nimwegen and others 2005, Van Nimwegen and Kirpensteijn 2007), ultrasonic devices (Hancock and others 2005), and different vessel‐sealing devices (Mayhew and Brown 2007, Culp and others 2009, Dupre and others 2009).…”

The Place of Laparoscopic Surgery in Surgical Gynaecology

“…The advantages of LAVH as compared to abdominal hysterectomy has been demonstrated in 7 prospective trials (23)(24)(25)(26)(27)(28)(29). Less pain, less use of analgesia, a reduction of 1-4 days in hospital stay, and a 14-28 day earlier return to normal activities were consistent results in all the trials (table 1 ) (23-29).…”

“…The development, safety, and efficacy of the laparoscopic myomectomy techniques has been established over the last 5 years (36). A small decline of 21% in use of laparotomy myomectomy between 1992 and 1997 probably dates from the increased use (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). The increase in the number of vaginal hysterectomies from 17.5 to 38% of operations between 1989 and 1997 is an advantage for the patient.…”