A Review of post-operative morbidity following laparoscopic assisted vaginal hysterectomy compared to conventional types of hysterectomy

Abstract

OBJECTIVE: To analyse the indications, morbidity and duration of hospital stay for laparoscopic assisted vaginal hysterectomy in comparison to other types of hysterectomy. DESIGN: A prospective cohort study. PATIENTS: All women undergoing hysterectomy dur¬ing the period of October 2000 to April 2002 at the University Obstetrics and Gynaecology Unit, Colombo-South Teaching Hospital. INTERVENTIONS: A patient questionnaire completed prior to surgery, on discharge from the hospital, and two weeks after surgery. Data extracted from patient's hospital case notes. MAIN OUTCOME MEASURES: Indications, operative complications, postoperative morbidity and length of hospital stay for different types of hysterectomy. RESULTS: 270 women underwent hysterectomy during this period, out of which 60% were total abdominal hysterectomies, 19.6% were vaginal hysterectomy and repairs, and 17% were laparoscopic assisted vaginal hysterectomies. Common indications for hysterectomy were fibroids (39.6%), uterine prolapse (19.6%) and severe dysfunctional uterine bleeding (11.5%). Mean postoperative hospital stay was 2 days for laparoscopic hysterectomy, 4 for vaginal hysterectomy and repair, and 5 for total abdominal hysterectomy. CONCLUSIONS: Laparoscopic assisted vaginal hysterectomy appears to be a better alternative to conventional hysterectomy with regard to post-operative morbidity and hospital stay in selected patients.