DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190305

Comparative clinical study of laparoscopic assisted vaginal hysterectomy and non-descent vaginal hysterectomy

Shobha S. Shiragur, B. Rajammal

Abstract


Background: Laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly becoming popular. It's really a technique made to replace abdominal hysterectomy. The need of the hour is the minimal invasive surgery, early discharge from the hospital, early resumption of work, avoidance of disfiguring scar on the abdomen and cost-effectiveness of the procedure which are as important as cure of the disease. The objective of this study is to compare the effectiveness and safety of laparoscopic and vaginal hysterectomies for non-descent uteri (NDVH).

Methods: The study was undertaken in the department of obstetrics and gynecology, Amrita Institute of Medical Sciences, Kochi for the period of one year. About 50 women in each group undergoing LAVH and NDVH for benign pelvic conditions were studied preoperatively, intra-operatively and post-operatively in detail for indications, operative time, intraoperative blood loss, duration of stay in hospital.

Results: The mean operative time in LAVH was 240.6 minutes and in NDVH 168.3 minutes. Minimum duration of stay was in LAVH 3 days and in NDVH 4 days. Mean duration of stay in both groups was 6.4 days. Maximum duration of stay-15 days in both groups.

Conclusions: LAVH is a better approach for a larger uterus whereas NDVH is preferable for a small uterus, not only for shorter operative time and minimal wound, but also for much lower costs.


Keywords


Hysterectomy, Laparoscopy, LAVH, NDVH

Full Text:

PDF

References


Bruhat MA, Mage G, Chapron C, Pouly JL, Canis M, Wattiez A. Presentday endoscopic surgery in gynecology. Eur J Obstet Gynecol Reprod Biol. 1991;41:4-13.

Richardson RE, Bournas N, Magos AL. Is laparoscopic hysterectomy a waste of time?. Obstet Gynecol Survey. 1995;50(8):590-1.

Coulam CB, Pratt JH. Vaginal hysterectomy: is previous pelvic operation a contraindication. Am J Obstet Gynecol. 1973;116:252.

Daraï E, Soriano D, Kimata P, Laplace C, Lecuru F. Vaginal hysterectomy for enlarged uteri, with or without laparoscopic assistance: randomized study. Obstet Gynecol. 2001;97(5):712-6.

Soriano D, Goldstein A, Lecuru F, Darai E. Recovery from vaginal hysterectomy compared with laparoscopy-assisted vaginal hysterectomy: a prospective, randomized, multicenter study. Acta Obstet Gynecol Scandinav. 2001;80(4):337.

Chang WC, Huang SC, Sheu BC, Chen CL, Torng PL, Hsu WC, et al. Transvaginal hysterectomy or laparoscopically assisted vaginal hysterectomy for nonprolapsed uteri. Obstet Gynecol. 2005;106(2):321-6.

Summitt RL Jr, Stovall TG, Steege JF, Lipscomb GH. A multicenter randomized comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy in abdominal hysterectomy candidates. Obstet Gynecol.1999;93(1):160.

Aniulienė R, Varžgalienė L, Varžgalis M. A comparative analysis of hysterectomies. Med. 2007;43(2):118.

Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC, Lee C. Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger than 6cm in diameter or uterus weighing at least 450g: a prospective randomized study. Acta Obstet Gynecol Scand. 2002;81(12):1132-8.

McCracken G, Hunter D, Morgan D, Price JH. Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy. Ulster Med J. 2006;75(1):54.

Doucette RC, Sharp HT, Alder SC. Challenging generally accepted contraindications to vaginal hysterectomy. Am J Obstet Gynecol. 2001;184(7):1386-91.

Garg PK, Deka D, Malhotra N. Non descent vaginal hysterectomy for benign condition. A better proposition than abdominal hysterectomy. Obstet Gynaecol Today. 2002;6:345-6.