title: Outpatient laparoscopic-assisted vaginal hysterectomy.
abstract: 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.
authors.affiliation: Bay Area Fertility Medical Group, Suite 4, 1855 San Miguel Drive, Walnut Creek, CA 94596, USA.
authors.forename: D I
authors.initials: DI
authors.lastname: Galen
authors.forename: A
authors.initials: A
authors.lastname: Jacobson
authors.forename: L N
authors.initials: LN
authors.lastname: Weckstein
mesh_terms: 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