Laparoscopically ? Assisted Vaginal Hysterectomy (LAVH) - An Alternative to Abdominal Hysterectomy

K Devendra, SK Tay
Correspondence: Dr Devendra Kanagalingam, dharkan@singnet.com.sg

ABSTRACT
Aim To study the outcomes of 42 consecutive patients who were scheduled for a laparoscopically-assisted vaginal hysterectomy (LAVH) between I January 1994 to 31 December 1999.
Method Retrospective study
Results Two patients required conversion to an abdominal hysterectomy. The range of uteri removed was from six to 16 weeks' size. Menorrhagia was the commonest presenting complaint and uterine fibroids was the commonest diagnosis. The mean duration of surgery (+/- SD) was 131.0 +/- 31.7 minutes. Mean blood loss (+/- SD) was estimated at 417 +/- 169 mls. Six percent of patients required a perioperative blood transfusion. Fifty-five percent of patients did not require any injectable analgesics and 45% were able to ambulate on the day of surgery. The mean duration of hospital stay (+/- SD) was 4.2 +/- 2.3 days;The commonest complication was post-operative fever.
Conclusion LAVH patients have a quick postoperative recovery with less pain at the expense of a long duration of surgery. LAVH is a feasible option in a selected group of patients who would otherwise require an abdominal hysterectomy.

Keywords: hysterectomy complications, minimally-invasive surgery, laparoscopy
Singapore Med J 2002; 43(3): 138-142