Gynaecology & Obstetrics

Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

It is a surgical procedure which is used to guide in the removal of the uterus or Fallopian tubes and ovaries through the vagina using a laparoscope.

Not all hysterectomies can be done by LAVH. In certain situations, a laparoscopic hysterectomy may be sufficient. In some other cases, an abdominal hysterectomy or a vaginal hysterectomy (without laparoscopy) is usually indicated. The surgeon will determine the right procedure for each individual case based upon the reason for the hysterectomy and also referring the medical history and conditions of the patients.

Why is this surgery used?

To treat disease of the uterus like: -

  • • Fibroids.
  • • Endometriosis.
  • • Infection in the ovaries or tubes.
  • • Pelvic pain.
  • • Overgrowth of tissue in the lining of the uterus.
  • • Abnormal vaginal bleeding.
How is LAVH performed?

Before the procedure, you will receive either a spinal and/or general anaesthesia before the surgery to keep you from feeling pain. The choice of anaesthesia is a decision that will be made by anaesthesia based upon your history and your wishes. Once the effect of anaesthesia starts, the doctor will remove the uterus, cervix, and possibly the ovaries and tubes through the vagina 4 small abdominal incisions. The laparoscope would act as a tiny telescope, having a camera attached to it, which will provide a continuous image that is magnified and projected onto a television screen for viewing.

During LAVH, the uterus is detached from the ligaments that attached to other structures in the pelvis using the laparoscopic tools. And in any case, If the Fallopian tubes and the ovaries are to be removed, they are also detached from their ligaments and blood supply. The organs and tissue are removed through an incision made in the vagina. The vaginal opening is then closed with suture.

Vaginal Hysterectomy (VH)
What is vaginal hysterectomy?

Vaginal hysterectomy is a surgical procedure wherein the uterus is removed through the vagina rather than through the incision in the abdomen.

Good candidates for vaginal hysterectomy

Individuals with the following conditions and those who don't have enlarged uterus are considered as eligible candidates for vaginal hysterectomy,

  • • Uterine prolapse.
  • • Endometriosis.
  • • Cervical dysplasia.
  • • Uterine fibroids.
How is VH performed?

Before the procedure, you will receive either a regional and/or general anaesthesia before the surgery to keep you from feeling pain. The choice of anaesthesia is a decision that will be made by anaesthesia based upon your history and your wishes. Once the effect of anaesthesia starts, the surgeon will make a small incision in the vagina and uterus is removed through it. The incision in the vagina is then closed with the absorbable stitches.

What to expect after the vaginal hysterectomy?

Recovery after a vaginal hysterectomy is quite very fast. Painkillers and antibiotics is given for pain and to prevent any infections. Bleeding from vagina is normal and will last for few weeks after the surgery. Sanitary pads should be used instead of tampons as the latter will increase the risk of infection. If ovaries and fallopian tubes are removed along with uterus in vaginal hysterectomy, then you might experience vaginal dryness or hot flashes, the symptoms of menopause. These may be treated with medicines, if required. You will be able to do normal activities in around two weeks after the surgery but should not lift heavy objects or have vaginal intercourse until the sixth week or till the complete healing occurs.

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