Laparoscopic-assisted vaginal hysterectomy: Initial experience

We reviewed the charts of 36 women who had had laparoscopic-assisted vaginal hysterectomies (LAVH) at Belfast City Hospital over a 3 year period. The average operating time was 105 minutes. However, patients had a shorter duration of hospitalisation (<4 days for 96% of patients) with rapid recuperation (3.4 weeks). Complications occurred in 7 patients. One patient developed a vesico-vaginal fistula which was diagnosed post operatively and successfully repaired 5 months later. Technical difficulty was reported in one patient because of significant adhesions and poor access due to obesity. She went on to develop a pelvic abscess which was drained. Patient satisfaction with the operation was high. LAVH is an effective operation in selected cases and in experienced hands the complication rate is low. In the future it may become a valid alternative to open abdominal hysterectomy.