Two-year experience with Laparoscopically Assisted Vaginal Hysterectomy (LAVH) in Maharaj Nakorn Chiang Mai Hospital: A Retrospective Comparative Study with Total Abdominal Hysterectomy

Abstract

Objective To describe our experience with laparoscopically assisted vaginal
hysterectomy (LAVH) and compare the results with total abdominal hysterectomy
(TAH).

Methods         Medical records of the LAVH cases were reviewed. The next patients

who had a TAH served as controls. Controls were matched with regard to age (+ 5
years) and body weight (+10 kg).      

Main outcome measures     Operative times, amount of blood loss, postoperative

analgesic requirement, days in hospital and serious complications. 

Results           Baseline characteristics in both groups were comparable. Operative

time was significantly longer (p=<0.001) in the LAVH group (176.5 + 43.5 minutes)
than the TAH group (121.4 + 31.2 minutes). There was no significant difference in
the amount of estimated blood loss (LAVH group 354.2 + 205.2 ml; TAH group
397.9 + 253.9 ml). A case of bowel injury and one of ureteral injury occurred in the
LAVH group. No serious complications occurred in the TAH group. The median
number of Meperidine dosage was significantly lower in the LAVH than that in the
TAH group (median of 1 versus 2 doses, p=0.034). Hospital stay was significantly
shorter in the LAVH group (median of 3 versus 4 days, p=0.001). No patient
required blood transfusion.
Conclusions LAVH is an excellent alternative to TAH. It offers several benefits over
TAH such as less postoperative pain and shorter hospital stay. However, LAVH
needs a learning period and a longer operative time.