Early outcomes of laparoscopic-assisted vaginal hysterectomy versus laparoscopic supracervical hysterectomy.

STUDY OBJECTIVE

To compare two different laparoscopic techniques for hysterectomy: laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH).

DESIGN

A retrospective review of office and hospital charts, and a postoperative questionnaire completed by patients.

SETTING

A private gynecology practice and private hospital in Nashville, Tennessee.

PATIENTS

Forty women requiring laparoscopic hysterectomy between January 1993 and December 1994. Interventions. Twenty patients underwent LAVH and 20 LSH. Minimum follow-up was 3 months (range 3-27 mo).

MEASUREMENTS AND MAIN RESULTS

The chart review focused on operating times, blood loss, length of hospital stay, complications, and total hospital costs to the patients. The operating times were shorter and the blood loss was less in the LSH group than in the LAVH group, but the difference did not reach statistical significance. Hospital stay was shorter (p = 0.0005) and hospital costs were less (p = 0.01) in the LSH group. Of women who were sexually active, those in the LSH group resumed intercourse earlier than those in the LAVH group (3.5 vs 5.9 wks), and reported better overall improvement in sexual function and ability to achieve orgasm.

CONCLUSION

In certain patients, LSH is effective and associated with few complications.