scholarly journals Converting Potential Abdominal Hysterectomy to Vaginal One: Laparoscopic Assisted Vaginal Hysterectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Jyothi Shetty ◽  
Asha Shanbhag ◽  
Deeksha Pandey
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Clinical Results ◽  
Abdominal Hysterectomy ◽  
Pain Scores ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Lower Pain ◽  
The Mean ◽  
The Difference ◽  
Laparoscopic Assisted

Background.The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy.Material and methods.A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise.Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06+31.97 min versus 135.25+31.72 min;P<0.05). However, the mean blood loss in LAVH was 100 mL lesser than that in abdominal hysterectomy and the difference was found to be statistically significant (248.24+117.79 mL versus 340.00+119.86 mL;P<0.05). Another advantage of LAVH was significantly lower pain scores on second and third postoperative days. Overall complications and postoperative hospital stay were not significantly different between the two groups.

scholarly journals The route of hysterectomy: a comparative study between abdominal hysterectomy (AH), non descent vaginal hysterectomy (NDVH), and laparoscopic assisted vaginal hysterectomy (LAVH)

2018 ◽  
Vol 7 (10) ◽  
pp. 4022 ◽  
Author(s):  
Prashaant Uikey ◽  
Trupti M. Wankhede ◽  
Megha P. Tajne
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Clinical Results ◽  
Abdominal Hysterectomy ◽  
P Value ◽  
Vas Score ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Hysterectomy is the most common operation performed by the gynaecologist. The uterus can be removed using any of the technique and approaches, including abdominal, vaginal, laparoscopic. There are no formal guidelines available regarding the most appropriate route of hysterectomy. Hence, a comparison of the clinical results of the three routes of hysterectomy is needed.Methods: a prospective study was performed at Indira Gandhi government medical college Nagpur between September 2015- October 2017, among 150 women indicated to undergo hysterectomy for benign and mobile uterine conditions. They were assigned 50 each to three routes of hysterectomy (abdominal, non-descent vaginal hysterectomy and Laparoscopic assisted vaginal hysterectomy). Outcome measures including operating time, blood loss, fall in haemoglobin, intra-operative complications, duration of analgesia, VAS score, hospital stay and post-operative morbidity were assessed and compared between the three groups.Results: Fibroid uterus (65.33%), was the commonest indication for hysterectomy. As far as operating time, intra-operative blood loss, fall in haemoglobin, duration of analgesia, VAS score and hospital stay P Value was significant among the three group. Incidence of complications was least in the NDVH group.Conclusions: In developing country like India with poor health care resources, scarcity of beds and non-availability of sophisticated equipment NDVH offers a distinctive advantage over other route of hysterectomy and should be the route of choice for benign uterine conditions.

scholarly journals Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy

1997 ◽  
Vol 3 (4) ◽  
pp. 231-239
Author(s):  
L. Mettler ◽  
N. Lutzewitsch
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Surgical Techniques ◽  
Abdominal Hysterectomy ◽  
Supracervical Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Indications For Operation ◽  
Laparoscopic Assisted ◽  
Benign Disorders ◽  
The University

Between 1993 and 1994, 368 women underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomy Classic Intrafascial Supracervical Hysterectomy (CISH). Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by Intrafascial Vaginal Hysterectomy (IVH), 12.2% by Vaginal Hysterectomy (VH), and only 0.05% by Laparoscopic Assisted Vaginal Hysterectomy (LAVH). Comparative data of these six surgical techniques concerning patients characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weights and postoperatively used analgesics are described.

scholarly journals LAPAROSCOPIC HYSTERECTOMY

2016 ◽  
Vol 23 (02) ◽  
pp. 166-170
Author(s):  
Zohra Kahnum ◽  
Amna Kahnum ◽  
Aman ur Rehman ◽  
Liaqat Ali
Keyword(s):  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Minimal Invasive ◽  
Safe Procedure ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Proper Training ◽  
Laparoscopic Assisted ◽  
Routine Procedures

Introduction: In current era, the trend for minimal invasive surgery is increaseddue to its established advantages. With the same, there increasing trend for laparoscopichysterectomy. But it carries certain risks in certain situations. Objectives: The study wasconducted to see the outcome of laparoscopic hysterectomies. Study Design: Retrospective,analytic study. Study Period: June 2012 to May, 2015. Method: A study was conducted to reviewthe outcome of Laparoscopic hysterectomy over a period of three years from June 2012 to May2015. Total one hundred cases were included in the study. These patients had hysterectomyeither total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy. Afterpreoperative evaluation, hysterectomy was done either total laparoscopic or laparoscopicassisted vaginal hysterectomy. Data was collected regarding patients profile variables,indications for hysterectomy, intraoperative findings, intraoperative time, postoperative recoveryfindings, analgesia requirements and discharge time from the hospital. Results: Results of thestudy showed that there was no significant increase in complication of urinary tract or bowelinjury. Operative time was decreased with time. Most common indication for hysterectomywas fibroid uterus or dysfunctional uterine bleeding. Patient recovery was smooth and postoperativeanalgesia was much less as compared to the routine. Patient hospital stay was lessas compared to the routine procedures for hysterectomy. Conclusion: It is concluded fromthe study that laparoscopic hysterectomy is safe procedure with the clear advantages for thepatient. In the study complication rate, operating time was comparable to the already publishedstudies. With proper training it is acceptable alternate to abdominal hysterectomy with clearadvantages for the patient.

scholarly journals HYSTERECTOMY

2012 ◽  
Vol 19 (02) ◽  
pp. 214-221
Author(s):  
M. IKRAM ◽  
SHAZIA JABEEN ◽  
M. SAEED
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Group A ◽  
Wound Discharge ◽  
The Mean ◽  
Group B ◽  
Laparoscopic Assisted

Abdominal hysterectomy, the procedure by which almost 90% of hysterectomies are currently being done. Laparoscopicassisted vaginal hysterectomy has been introduced as an alternative to abdominal hysterectomy, and is thought to allow a more rapid return tonormal activity. Laparoscopic assisted vaginal hysterectomy has less postoperative morbidity and quicker recovery than abdominalhysterectomy. Objective: To compare the laparoscopic assisted vaginal hysterectomy with total abdominal hysterectomy in term of operativetime, per operative blood loss and post-operative wound infection. Study Design: Randomized trial. Setting: This study was carried out in thedepartment of obstetrics and gynaecology, Shaikh Zayed Hospital, Lahore. Period: Six months (15th September, 2008 to 15th March 2009).Patients and methods: Eighty patients fulfilling the inclusion criteria were selected for this study. Patients were equally divided in two groups;group A (laparoscopic assisted vaginal hysterectomy) and group B (total abdominal hysterectomy). Operative time (in minutes), blood loss (inml) as estimated and post-operative wound infection was assessed by presence or absence of wound discharge, redness and edema aroundthe incision on 3rd, 5th and 7th post-operative day. Results: The mean ages of women in group A was 49.13+4.26 and 45.68+4.54 years ingroup B. The maximum number of parity between 3-4 was 19 in group A and 20 in group B. Mean weights of cases in group A was 65.60+10.45kilograms and 70.77+15.59 kilograms in groups B. The per-operative time in group A was 105.13+6.55 minutes and 83.38+14.82 minutes ingroup B. The mean blood loss in group A was 178.0+43.51 ml and 228.25+72.49 ml in group B. The wound discharge was not found in group A,while in group B, 4 cases (10%) on 3rd post-operative day, 6 cases (15%) on 5th post-operative day and 11 cases 27.5% on 7th post-operative.Conclusions: Laparoscopic assisted vaginal hysterectomy has a quicker post-operative recovery but at the expense of a bit long duration ofsurgery. Laparoscopic vaginal assisted hysterectomy is a feasible option in a selected group of patients who would otherwise require anabdominal hysterectomy. The drug requirement to control pain and level of pain experienced by patients were also significantly less.

scholarly journals Comparative study of intra and post-operative complications between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

2019 ◽  
Vol 8 (6) ◽  
pp. 2459
Author(s):  
S. Nithya Priya ◽  
S. Senthil Priya ◽  
S. Allirathnam ◽  
S. Nithya ◽  
R. Shankar
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Tamil Nadu ◽  
Perioperative Complications ◽  
Operating Time ◽  
Injury Rate ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
The Difference

Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of postoperative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (201 ml) compared to LAVH group (149.8 ml) and the difference was found to be statistically significant (p <0.05). Similarly, the duration of operative procedure was found to be less in LAVH group (57.9 mins) compared to TAH group (72.6 mins) and the difference was found to be statistically significant (p <0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the LAVH group and the difference was found to be statistically significant (p <0.05).Conclusions: LAVH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.

The Postoperative Inflammatory Response to Injury following Laparoscopic Assisted Vaginal Hysterectomy versus Abdominal Hysterectomy

1997 ◽  
Vol 34 (5) ◽  
pp. 543-545 ◽  
Author(s):  
M Labib ◽  
S Palfrey ◽  
E Paniagua ◽  
R Callender
Keyword(s):  
Inflammatory Response ◽  
Vaginal Hysterectomy ◽  
Tissue Injury ◽  
Abdominal Hysterectomy ◽  
Surgical Trauma ◽  
Laparoscopically Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted ◽  
Laparoscopic Techniques ◽  
Inflammatory Response To Injury

The magnitude of the inflammatory response to surgery depends on the degree of injury during surgical procedures. Laparoscopic techniques are generally associated with less postoperative pain and shorter hospital stay compared with open procedures, presumably due to less tissue injury and reduced inflammatory response. However, no study has been done, to our knowledge, to assess the inflammatory response to surgical trauma following laparoscopic assisted vaginal hysterectomy. We have, therefore, compared the magnitude of the inflammatory response to injury after laparoscopically assisted vaginal hysterectomy (11 patients) and abdominal hysterectomy (11 patients) by measuring serum C-reactive protein (CRP) and interleukin-6 (IL-6) on admission, and at 24 and 48 hours after the operation. Postoperatively, serum CRP rose significantly in both groups but levels in patients who underwent laparoscopically assisted vaginal hysterectomy were significantly lower than in those who underwent abdominal hysterectomy. Serum IL-6 rose significantly after abdominal hysterectomy but not after laparoscopically assisted vaginal hysterectomy. Our results show that the inflammatory response to surgical trauma was significantly less after laparoscopically assisted vaginal hysterectomy than after abdominal hysterectomy confirming that the laparoscopic procedure causes less tissue damage than the abdominal procedure.

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