Comparative study of non-descent vaginal hysterectomy and laparoscopy assisted vaginal hysterectomy

Background: We aimed to assess and compare intra operative and post-operative parameters and complications associated with non-descent vaginal hysterectomy group (NDVH) and laparoscopic assisted vaginal hysterectomy group (LAVH).Methods: In this observational study 100 patients with uterine size not exceeding 12 weeks of gravid uterus, adequate uterine mobility, fibroid uterus, dysfunctional uterine bleeding, chronic cervicitis, adenomyosis and post-menopausal bleeding were divided into two groups to undergo either NDVH and LAVH. Their intra-operative and post-operative parameters were compared.Results: The mean operating time was significantly less in NDVH group as compared to LAVH group cases (65.44 vs 83.12 mins; p<0.01). Blood loss (210.22 vs 261.58 ml; p-0.03) during the procedure and drop in haemoglobin (1.22 vs 1.62 gm%; p-0.08) was also lower with NDVH group as compared to LAVH group respectively. Requirement of blood transfusion, adnexotomy and incidence of anaesthesia related complications were similar between the two study groups. Median VAS score was significantly less in NDVH group as compared to LAVH group at immediate post-op period and at day 1 respectively (p<0.01). We observed a comparable mean hospital stay for the patients in the two study groups (5.52±1.33 vs 6.01±1.39 days, p value=0.71).Conclusions: Based on the results of the present study, we conclude that NDVH is safe and should be offered as the first surgical choice in women with uterine enlargement due to benign pathology and non-prolapsed uterus.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184123 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4022 ◽

Cited By ~ 1

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.

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Evaluation of outcome following paracervical infiltration with or without saline and adrenaline during vaginal hysterectomy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171953 ◽

2017 ◽

Vol 6 (5) ◽

pp. 1942

Author(s):

Jayaraman Nambiar M. ◽

Bhaygarekha Yettinamani ◽

Muralidhar V. Pai

Keyword(s):

Vaginal Hysterectomy ◽

Postoperative Infection ◽

Case Control Study ◽

Operating Time ◽

Case Control ◽

P Value ◽

Laparoscopic Assisted Vaginal Hysterectomy ◽

Significant Difference ◽

Laparoscopic Assisted ◽

Control Study

Background: Paracervical infiltration is used in vaginal hysterectomy to facilitate dissection. Use of paracervical infiltration however can be associated with local ischemia and infection. We did a study to find out its benefits during vaginal hysterectomy.Methods: It was a prospective case control study. Patients were divided into two groups. In the first group, no paracervical infiltration was given. In the second group paracervical infiltration was given before hysterectomy. The operating time, blood loss and postoperative infection were noted in each group.Results: The operating time was slightly higher in vaginal hysterectomy group without infiltration (p=0.025) The operating time in laparoscopic assisted vaginal hysterectomy group was not significant (p=0.0296). There was significant difference in Hemoglobin after surgery in both groups (p value 0.614 for vaginal hysterectomy and 0.173 for laparoscopic assisted vaginal hysterectomy). There was no case of infection in both groups.Conclusions: From our study, we concluded that paracervical infiltration offers no distinctive advantage during vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy.

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Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.3.231 ◽

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.

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LAPAROSCOPIC HYSTERECTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.02.1062 ◽

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.

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

Minimally Invasive Surgery ◽

10.1155/2014/305614 ◽

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.

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