Laparoscopically Assisted Vaginal Hysterectomy: A Review of 106 Cases

Martel, Marie J.; Gilliland, G.B.

doi:10.1089/lps.1995.5.371

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…Since the first report 4 of laparoscopic‐assisted vaginal hysterectomy (LAVH), many centres have described their experience with the use of laparoscopic access in performing hysterectomy, varying from LAVH to total laparoscopic hysterectomy. 5–9 After nearly 10 years of experience with laparoscopic hysterectomy, especially LAVH, we have audited the hysterectomies performed in our department over a period of 6 years, to assess the effects of the introduction of laparoscopic techniques on the use of traditional methods.…”

Section: Introductionmentioning

confidence: 99%

Hysterectomy for benign uterine disease: the effect of the introduction of laparoscopic‐assisted hysterectomy on the selection of surgical access

et al. 2000

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Objective To investigate the effect of the introduction of laparoscopic surgery on the use of traditional techniques of hysterectomy. Design A retrospective study of hysterectomies performed for benign uterine disease, between August 1991 and July 1997. Setting University hospital. Subjects Patients requiring hysterectomy for benign uterine disease without prolapse or pelvic floor relaxation. Interventions 359 hysterectomies including vaginal (n = 211), laparoscopically assisted vaginal (n = 56), and abdominal (n = 92). Results The main indications for hysterectomy were profuse uterine bleeding and pelvic pain; uterine fibroids were a common occurrence (87%). There were no statistical differences between the mean ages of the patients in the three groups. The mean parity was significantly lower (P = 0.04) for patients undergoing abdominal hysterectomy (AH) (1.3 ± 1.4) than for those whose surgery was either vaginal (2 ± 1.5) or laparoscopic (1.8 ± 1.6) . Before the introduction of laparoscopic‐assisted vaginal hysterectomy (LAVH) (1989–90), the rates of vaginal hysterectomy (VH) and abdominal hysterectomy (AH) in our department were, respectively, 42% and 58%. In the initial 3 years of the study period, the rate of abdominal hysterectomy stayed stable around 30%, then dropped gradually to 18% (P < 0.05). The rate of LAVH stayed stable during the initial 4 years (between 22 and 24%) and declined thereafter to 7% (P < 0.05). The rate of VH stayed stable during the initial 4 years (between 46 and 56%) and then increased gradually to 75% (P < 0.05) and more specifically to 90% in patients who had no prior vaginal childbirth. During the last 2 years of the study there was a decrease in the use of the laparoscopic approach in favour of the vaginal route. Conclusion In our institution the introduction of LAVH led to expected changes during the initial 3 years of the study period, producing a major decline in the rate of AH in favour of LAVH. The unexpected development during the second 3 years of the study period was a further decline in the rate of AH along with a significant decline in the rate of LAVH, both in favour of VH.

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Section: Introductionmentioning

confidence: 99%

Hysterectomy for benign uterine disease: the effect of the introduction of laparoscopic‐assisted hysterectomy on the selection of surgical access

et al. 2000

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“…[3][4][5][6][7][8] Comparison of cases of the previous investigators is difficult because of lack of standardization of the laparoscopic part, as different techniques and level of dissection have been used. It appears that classification offered by Munro Late publications reveal LAVH being as or less expensive than TAH, when reusable instruments are used instead of disposables for cautery and haemostsis.7'8 Previously we compared the outcome of 61 LAVH cases to 65 TAH in 1994.5 Now we are presenting results and outcome of 190 cases of hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopically Assisted Vaginal Hysterectomy: Report of 190 Cases

Riza

1997

Journal of Laparoendoscopic & Advanced Surgical Techniques

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We report 190 cases where laparoscopy assisted vaginal hysterectomy (LAVH) was used as a primary procedure when the patients were not suitable candidates for a vaginal hysterectomy (VH) either because of lack of prolapse or multiple abdominal surgeries. All the surgeries were done by the same gynecologist. A total of 209 cases were performed, but 8 cases (3.8%) have been converted to TAH because of intraoperative bleeding or severe adhesions. The remaining 201 (96.2%) cases have been completed as LAVH. In this study we have evaluated only 190 cases as 19 cases had additional associated surgeries or incomplete records. The average operating time was 117+/-25.9 min, the intraoperative blood loss was 242.3+/-213.3 mL, and the average hospitalization was 0.7+/-0.7 days. Although the operating time and intraoperative blood loss over a span of time showed significant reduction, the hospitalization did not show any significant change. The complication rate was 6.6%. The average hospitalization cost excluding the surgeons and anesthesiologist charges was $3936.00. With these findings we have concluded that regardless of preoperative diagnosis and findings when vaginal hysterectomy is not suitable, LAVH is a viable alternative to TAH. To the best of our knowledge this is the first article discussing this particular approach.

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