Laparoscopically assisted vaginal hysterectomy.
OBJECTIVE
To report our experience with laparoscopically assisted vaginal hysterectomy (LAVH) and evaluate the advantages of LAVH.


METHODS
From January 1991 to August 1992, 176 LAVHs were performed at the Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University, Seoul, Korea. The indications for LAVH, based on the preoperative diagnosis, were uterine myomas, dysmenorrhea, chronic pelvic inflammatory disease or pelvic pain, dysfunctional uterine bleeding and cervical intraepithelial neoplasia (in order of frequency).


RESULTS
Patients had concomitant procedures, including incidental appendectomy, posterior wall repair, pelvic adhesiolysis and salpingo-oophorectomy. Bipolar forceps were used to compress and desiccate vessels. The Nd-YAG laser, scissors and/or unipolar electrode were used for tissue division, excision of adhesions and cutting. The intraoperative complications were bladder perforation, massive hemorrhage and inferior epigastric vessel injury (one case each). The postoperative complications were infection, voiding difficulty, febrile morbidity, pelvic abscess, incisional hernia, vaginal vault bleeding and peroneal nerve palsy (one case each).


CONCLUSIONS
Hysterectomy can be safely performed vaginally assisted by operative laparoscopy by well-trained laparoscopists, resulting in reduced surgical morbidity, blood loss, postoperative discomfort, recovery time and hospitalization.
Hur
M
M
Department of Obstetrics and Gynecology, Chung-Ang University, Seoul, Korea.
Kim
J H
JH
Moon
J S
JS
Lee
J C
JC
Seo
D W
DW
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D018579:Patient Selection; D014591:Uterine Diseases / Q000601:surgery*