scholarly journals Laparoscopic assisted vaginal hysterectomy: an experience at a Fortis Escorts hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 3749
Author(s):  
Neelu Rajput ◽  
Sahab Singh Yadav ◽  
Pratibha Narwade
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Pelvic Surgery ◽  
Bladder Injury ◽  
Duration Of Hospital Stay ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: The objective of this study was to evaluate the laparoscopic assisted vaginal hysterectomy (LAVH) in terms of demographic data of patients, indications, uterine size, intraoperative and postoperative complications, amount of blood loss, operative time and duration of hospital stay.Methods: A retrospective study was conducted on 160 cases, who underwent laparoscopic assisted vaginal hysterectomy in the period between October 2018 to November 2019 at the Fortis Escorts Hospital, Faridabad, Haryana, India.Results: Majority of patients (58.75%) belongs to age group between 40-50 year. Only 30.62% cases had a history of one previous abdomino-pelvic surgery. Majority of cases (52.5%) in the study group had uterine size between 6-12 weeks. Most common indication of hysterectomy in this study was fibroid uterus which account for 49.37% of cases followed by dysfunctional uterine bleeding (16.87%) cases. Mean time of surgery in this study was 114.4±0.59 min and average blood loss was 135.62±47.63 ml. The mean weight of uterus was 243.75±82.94 gm. 5% cases had major intraoperative complications while minor postoperative complications were seen in 16.87% cases. Bladder injury was seen in 1.25%. Major haemorrhage occur in 1.25%. In this study conversion to laparotomy rate was 1.25%. Only one case of ureteric injury and one case of bowel injury was noted. Among minor complications fever (6.25%) and urinary tract infection (5.62%) were mainly seen. Mean duration of hospital stay was 2.82±1.17 days.Conclusions: LAVH enables the surgeon to convert most of the abdominal hysterectomies into vaginal ones and hence decreases postoperative pain, decreases complications, lesser duration of hospital stay and rapid return to normal activity.

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 Comparative Study between Laparoscopic Assisted and Traditional Vaginal Hysterectomy

2019 ◽  
Vol 13 (2) ◽  
pp. 29-31
Author(s):  
Liza Chowdhury
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Armed Forces ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Post Operative Pain ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Laparoscopic Assisted

Introduction: The choice of hysterectomy approach depends on the reason for hysterectomy, the overall health of the patient and surgeon’s experience. The choice of technique dictates hospital stay and healing time. Objective: To compare the efficacy and outcome of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and traditional Vaginal Hysterectomy (VH). Materials and Method: A total of 100 patients were purposively selected for this prospective comparative study during the period of January 2011 to January 2013 in CMH, Dhaka and Hitech Multicare Hospital. Non-malignant patients undergoing LAVH and VH by the same surgeon were included in this study. Clinical variables such as operative time, operative cost, blood loss, quantity of analgesics used and hospital stay were observed in both cases for comparison. Several other variables were also observed as postoperative complications such as amount of haemoglobin decrease, rise of temperature, urinary tract infection, vault granuloma in both the cases. Results:  There was no significant difference in terms of age, parity, body weight, uterine weight. The mean estimated blood loss in VH (100±32.8 ml) was significantly lower compared to LAVH (126.5±39.8 ml) group. Comparing the relief of post-operative pain, less analgesic was required, rapid patient recovery, and hospital stay time was less in LAVH group than VH group. Conclusion: LAVH is clinically beneficial in terms of less post-operative pain and less quantity of analgesia used, rapid patients’ recovery and shorter hospital stay than VH. It is useful for patients who prefer laparoscopy for cosmetic purpose. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 29-31

scholarly journals Comparison of total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy – a 2-year retrospective study

2017 ◽  
Vol 6 (3) ◽  
pp. 966
Author(s):  
Kanmani Mani ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Statistical Difference ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Significant Statistical Difference ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Hysterectomy is one of the most commonly performed major surgeries. Recently, increasing number of minimally invasive approaches, such as TLH and LAVH has been applied. People undergoing laparoscopic hysterectomy experience shorter hospitalization, a smaller wound, more rapid recovery, and shorter absence from work compared to patients undergoing abdominal hysterectomy. The objective of present study is to compare the surgical short term results between Laparoscopic assisted vaginal hysterectomy (LAVH) and Total laparoscopic hysterectomy (TLH) in our centre in two years.Methods: This was a retrospective study of 93 women who underwent LAVH and 55 women who underwent TLH. The statistical analysis is done by using Students t-test, Chi-square test, and Mann-Whitney test appropriately.Results: There were no differences between the two groups with respect to age, BMI, Indication of surgery, Uterine size, Previous pelvic surgery, average blood loss and hemoglobin change (P=0.4). The duration of surgery was longer in TLH (124 min vs. 76.9 min) and is found to be extremely significant (P=0.0001). There was significant statistical difference in respect to hospital stay (P=0.0076). There was no significant statistical difference in various complication rates (P=0.22).Conclusions: Both TLH and LAVH are safe methods in performing hysterectomy, but LAVH has advantages over TLH with reduced operating time and less hospital stay even for the patients with history of previous pelvic surgery.

Laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy in stage I endometrial cancer

2002 ◽  
Vol 12 (1) ◽  
pp. 57-61 ◽  
Author(s):  
K. M Fram
Keyword(s):  
Endometrial Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Stage I ◽  
Laparoscopic Treatment ◽  
Laparoscopically Assisted Vaginal Hysterectomy

Abstract.Fram KM. Laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy in stage I endometrial cancer.The purpose of this study was to evaluate and compare laparoscopic treatment for stage I endometrial cancer with the traditional transabdominal approach. From July 1996 to July 1998, 61 patients with clinical stage I endometrial cancer were treated at the Gynaecology Oncology Unit at the Royal North Shore of Sydney, Australia. Twenty-nine patients were treated with laparoscopic assisted vaginal hysterectomy (LAVH) and bilateral salpingo-oophrectomy (BSO) ± laparoscopic pelvic lymphadenectomy (LPLA), while 32 patients were treated with the traditional laparotomy and underwent total abdominal hysterectomy (TAH) and BSO ± pelvic lymphadenectomy (PLA). The main outcomes studied were operative time, blood loss, blood transfusion, intraoperative complications, postoperative complications, duration of hospital stay, and number of lymph nodes obtained. In conclusion, laparoscopic treatment of endometrial cancer is safe in the hands of experienced operators with minimal intraoperative and postoperative complications. This procedure is associated with significantly less blood loss and shorter hospitalization; however, it is associated with significantly longer operating time. Proper selection of patients for the laparoscopic procedure is the vital step in achieving the major goals of this approach.

scholarly journals Effect of anaesthesia on the perioperative outcomes of pelvi-acetabular fracture surgeries in the apex trauma centre of a developing country–a retrospective analysis

2015 ◽  
Vol 3 ◽  
pp. 1-6
Author(s):  
Naveen Yadav ◽  
Suma Rabab Ahmad ◽  
Nisha Saini ◽  
Babita Gupta ◽  
Chhavi Sawhney ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Acetabular Fracture ◽  
Regional Anaesthesia ◽  
Trauma Centre ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Abstract Background Regional anaesthesia has been proposed to reduce intraoperative blood loss, duration of hospital stay and in-hospital complications with improved postoperative pain control. General anaesthesia is advantageous for prolonged surgeries. We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries. Methods We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre. We excluded patients with incomplete records (n = 4) and other injuries operated along (n = 8). Hence, 59 patients were divided into three groups: G group (general anaesthesia), R group (regional anaesthesia) and GR group (combined regional and general anaesthesia). Main outcome measurements studied were intraoperative blood loss, duration of hospital stay, duration of surgery and intraoperative and postoperative complications. Results No differences were obtained in between the groups in terms of age, gender, Injury Severity Score, number of comorbidities, or duration from injury to surgery. No significant differences were found between the three groups for intraoperative blood loss, days of hospital stay and duration of surgery. Intraoperative and postoperative complications were also comparable between the groups (p > 0.05). Conclusions There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.

scholarly journals Non-descent vaginal hysterectomy surgery associated with less complications and good prognosis

2022 ◽  
Vol 13 (1) ◽  
pp. 123-128
Author(s):  
Pranita Somani ◽  
Priyanka Singh ◽  
Mangala Shinde
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Vaginal Discharge ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Vaginal Route ◽  
Background Removal ◽  
Operative Complications ◽  
Post Operative Complications

Background: Removal of the uterus through vagina when performed in a case without uterine descent or prolapse is known as “non-descent vaginal hysterectomy” or NDVH. Vaginal route is preferred as compared to laparoscopic and abdominal methods. The advantages of vaginal hysterectomy being fewer complications, less post-operative stay, cost effective, and useful in bulky uterus. Aims and Objectives: The aims of the study were as follows: (1) To study the intraoperative and post-operative complications encountered during NDVH and their management. (2) To assess the intraoperative blood loss, the operative time, and post-operative hospital stay. (3) To study and check the feasibility of vaginal route as the primary route for all hysterectomies in the absence of uterine prolapse. Materials and Methods: A total of 50 patients were included in the study. Detailed history was taken including obstetric history and menstrual history and clinical examination was performed. After taking written, informed consent and doing proper pre-operative preparation, the patient was posted for NDVH. Post-operative complications were noted. Patients were asked to come for follow-up after 15 days. Results: In 92% of cases operated, no intraoperative complications were found suggesting low morbidity associated with the procedure. Hemorrhage requiring blood transfusion was found in 4% of cases. Average operative time was 61.2 ± 27.89 min, average blood loss was 170 ± 81.44 ml, and average hospital stay was 5.94 ± 4.95 days. On histopathological examination, 40% were having leiomyoma and dysfunctional uterine bleeding was seen in 22% of cases. Pain was the most common complication seen in 30% of cases while vaginal discharge was seen in just 4% of cases. About 80% of patients were discharged on post-operative day 5. Conclusion: In 92% of NDVH cases, no intraoperative complications were found suggesting low morbidity associated with the procedure. The post-operative hospital stay was restricted to 5 days in 80% of cases which indicates early discharge of the patient. Post-operative complications such as vaginal discharge and fever were seen only in 4% of cases. NDVH should, therefore, be considered as the primary route for all hysterectomies unless contraindicated in the absence of prolapse.

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