Laparoscopically assisted vaginal hysterectomy as an alternative to abdominal hysterectomy in patients with fibroids.

OBJECTIVE

Introduction of laparoscopically assisted vaginal hysterectomy (LAVH) was evaluated for its usefulness to replace abdominal hysterectomy in fibroids.

STUDY DESIGN

A total of 240 women with a mean age of 46.7 years underwent hysterectomy over a period of one year. The technique of LAVH was introduced starting in the second quarter of the study period. Clinical data of 60 patients undergoing either LAVH or abdominal hysterectomy for fibroids were compared in a cross-sectional study by chi 2- and t-test.

RESULTS

A comparison between the first and the last quarter of the study period showed that the rate of abdominal hysterectomies decreased from 66% to 12%, whereas LAVH increased from 0 to 40% (p < 0.05). The rate of vaginal hysterectomies remained between 34% and 48%. Compared to abdominal hysterectomy, LAVH operating time was about 1/3 longer, hospital stay was shorter (3 days), and LAVH proved more cost-effective than abdominal hysterectomy (significance of all differences: p < 0.05).

CONCLUSIONS

LAVH is a valid alternative to abdominal hysterectomy in fibroids.