LAVHLaparoscopically Assisted Vaginal Hysterectomy
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To establish in a retrospective study whether LAVH may allow hysterectomy to be performed safely by the vaginal route; however the most important outcome was to assess the impact of this approach on the total number of VHs performed without laparoscopic assistance over a period of 10 years.
This prospective, randomized, double-blinded study was designed to evaluate the effects of four different groups of solutions administered intraoperatively during LAVH on patients at a tertiary medical center.
Conclusions: LAVH operating times decreased after a surgical benchmarking and education intervention, but operating charges did not.
The study group comprised women admitted for AH for benign uterine conditions who were selected to undergo LAVH, provided they met the following criteria:
Ghomi and his associates from Harvard Medical School, Boston, and the State University of New York at Buffalo, where he is a member of the department of gynecology-ob-stetrics, evaluated 248 successive cases of LAVH and 173 successive cases of LSH between January 2001 and December 2007.
Fader, of the division of gynecologic oncology at the Cleveland Clinic Foundation, and her colleagues performed a retrospective review of patients with early-stage endometrial cancer treated with TLH or LAVH between 1998 and 2006 at two academic facilities.
The TLH group had a mean stay of 8 hours, and the LAVH group, 19 hours.
As I see it, the laparoscope can be used to address situations that result in uterine immobility, such as nulliparity, adhesions, and endometriosis, thus allowing conversion of these cases to LAVH.
Patients who underwent LAVH had increased postoperative symptoms that included vaginal discharge, postoperative bladder and bowel symptomatology, increased back pain, and decreased libido and coital frequency.
CPT code 58550 covers LAVH for a uterus weighing less than 250 g.
Two of four port-site recurrences of uterine cancer occurred at manipulative port sites, and all appeared a median of 14 months after LAVH with or without dissection.
This approach minimizes the number of incisions required to perform LAVH, which decreases risk for injury and complication, In this case series, healing was rapid and cosmetic outcome was superior to techniques involving more trocars, Dr.