Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

LAVH combines laparoscopy and hysterectomy. Laparoscopy is used to look into the abdomen at the reproductive organs. Hysterectomy is surgery to remove the uterus.

What Is LAVH?

LAVH is a special form of hysterectomy - removal of the uterus. The uterus is a reproductive organ in the lower abdomen. The uterus can be removed in two ways. When it is removed through a cut (incision) in the abdomen, the procedure is called an abdominal hysterectomy. When it is removed through the vagina, it is called a vaginal hysterectomy.

LAVH involves the use of a small, telescope-like device called a laparoscope. The laparoscope is inserted into the abdomen through a small cut. It brings light into the abdomen so that your doctor can see inside.

The laparoscope also can be used before hysterectomy to look at the pelvic organs to help your doctor see what conditions are present.

Reasons for LAVH

Hysterectomy may be offered as a treatment option for problems with the uterus.

Following are reasons to perform LAVH:

• Adhesions
• Endometriosis
• Fibroids
• Salpingo-oophorectomy. If the ovaries and fallopian tubes also are removed during hysterectomy, it is called salpingo-oophorectomy.

The Procedure

Before LAVH, certain steps will be taken to prepare you for the procedure:

• Your pelvic area and abdomen may be shaved.
• You will be given an intravenous (IV) line.
• You will be given anesthesia (pain relief). You will not be awake during the surgery.

In some cases, an abdominal hysterectomy may be required if an LAVH could not be done.

Benefits

The main reason for LAVH is to allow the uterus to be removed safely through the vagina if a standard vaginal hysterectomy cannot be done.

Risks

There are some risks that may occur with any surgery. These may include:

• Bleeding
• Infection
• Problems from the anesthesia
• Blood clots in the veins or lungs
• Death (rare)

LAVH can take longer than other types of hysterectomy. This means that you may need more anesthesia than you would with other forms of hysterectomy.

After Surgery

Hysterectomy is major surgery, no matter how it is done. You will have some pain. You may need to stay in the hospital for a few days.

After you leave the hospital, you will need to rest and take care of yourself.

Make sure you know the warning signs of a problem. Contact your doctor if you have any of the following:

• Fever or chills
• Heavy bleeding or vaginal discharge
• Severe pain
• Redness or discharge from the abdominal cuts
• Problem with urination or bowel movements
• Shortness of breath or chest pain

Finally …

If you have problems with your uterus, you and your doctor may decide that a hysterectomy is the best treatment. LAVH may be an option.