Outpatient laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To compare laparoscopic-assisted hysterectomy (LAVH) with conventional abdominal hysterectomy.


METHODS
First 50 consecutive LAVH procedures.


METHODS
An outpatient facility at a major medical center (35 procedures) and a nonhospital free-standing surgicenter (15).


METHODS
Sequential sample of 50 women requiring hysterectomy.


METHODS
LAVH in 46 women, converted to open laparotomy in 4.


RESULTS
Outpatient LAVH was performed successfully in the majority of women. Most patients had significant uterine enlargement, pelvic adhesions, or endometriosis. Only six required replacement of autologous blood postoperatively. Other complications were cystotomy and postoperative pelvic hematoma in one patient each.


CONCLUSIONS
LAVH can be performed safely in free-standing surgicenters. It offers several advantages to patients, and is considered cost effective by third-party payers.
Galen
D I
DI
Bay Area Fertility Medical Group, Suite 4, 1855 San Miguel Drive, Walnut Creek, CA 94596, USA.
Jacobson
A
A
Weckstein
L N
LN
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D002140:California; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D012016:Reference Values; D012494:Sampling Studies; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery