LAVH (Laparoscopic Assisted Vaginal Hysterectomy)

Why might someone need a Hysterectomy?

A hysterectomy might be considered when a woman's gynaecologic condition is seriously impacting her quality of life or when other therapies have not helped.

Common causes include,

• Uterine fibroid causing heavy bleeding, Pressure symptoms or pain.
• Adenomyosis, heavy periods and chronic pelvic pain.
• Abnormal uterine bleeding.
• Endometriosis causes chronic pelvic pain.
• Uterine prolapse and certain precancerous or cancerous conditions of the reproductive tract.

The decision to undertake a hysterectomy will be individual and depend on the patient symptoms, health and treatment objectives.

What is Laparoscopic Assisted Vaginal Hysterectomy (LAVH)?

LAVH is a combination of two surgical methods laparoscopy and vaginal delivery used together in the removal of the uterus.

• Small incisions are made in the abdomen where laparoscopic instruments are inserted.
• A camera is used to magnify the view of the organs in the pelvis.
• The surgeon uses laparoscopic assistance to separate the uterus from other organs in the abdomen.
• The uterus is removed through the vagina.

This can minimize surgical trauma and enable the surgeon to visualize and manage the pelvis more effectively.

How is LAVH is different from other types of Hysterectomy?

Many patients do not know that there are other methods of hysterectomy.

Abdominal Hysterectomy

• A larger incision in the abdomen is required and has a longer recovery typically.
• Required in more complicated cases.

Vaginal Hysterectomy

• The uterus is completely removed through the vagina without making any abdominal incisions.

Laparoscopic-Assisted Vaginal Hysterectomy (LAVH)

• Uses both laparoscopy and vaginal surgery, offers better visualization of the pelvic structures.
• allows treatment of some condition that may be more difficult using only vaginal surgery.

Total Laparoscopic Hysterectomy (TLH)

• The entire procedure is performed laparoscopically.
• The uterus may be removed through the vagina or through small abdominal incisions.

Who is suitable for LAVH?

LAVH might be an option for women who have,

• Fibroids and experience heavy periods.
• Who are diagnosed with adenomyosis or endometriosis.
• Who need a hysterectomy for benign gynaecologic conditions.
• Who would benefit from a minimally invasive surgical procedure.

But not all patients are suitable and sometimes other methods are more suitable.

What are the benefits of LAVH?

LAVH has several benefits over the conventional abdominal hysterectomy.

They can include,

• Fewer cuts and small scarring.
• Less pain and discomfort after surgery.
• Less blood loss during surgery.
• Shorter hospital stays.
• Faster recovery and return to daily activities.
• Lower risk of complications related to the scar or cuts.
• Better cosmetic appearance.

This has played a role in the rise in the use of less invasive methods for hysterectomy.

What are possible risk and complications?

While LAVH is a safe procedure on most occasions, any surgical procedure does have its risks. There are some possible risks that can occur during or after surgery such as,

• Bleeding.
• Infection.
• Injury to nearby organs (bladder, bowel, ureters).
• Blood clots in the legs or lungs.
• Anaesthesia related complications.

Your surgeon will explain these risks before surgery and address your questions.

Will I go through Menopause after LAVH?

One of the most common worries of patients who are thinking about having a hysterectomy.

If ovaries are preserved

• Hormone production continues.
• One will not experience Menopause right after the Hysterectomy.
• Menstrual periods will not occur because the uterus has been removed.

If Both Ovaries Are Remove

• Hormone levels decrease significantly.
• Surgical menopause may occur.
• Symptoms such as hot flashes, night sweats, and vaginal dryness may develop.

Patients have to talk with their gynaecologist about preserving their ovaries before surgery.

What can you expect during recovery?

Recovery after LAVH is generally faster than recovery after open abdominal hysterectomy.

Symptoms after surgery

• Pelvic pain or discomfort.
• Abdominal bloating.
• Changes in menstrual patterns.
• Light vaginal bleeding or discharge.

Recovery tips

• Walk regularly to improve circulation
• Drink good amount of water.
• Avoid heavy lifting until medically cleared.

What recent advances have improved LAVH?

• High-definition and 3D laparoscopy imaging, which gives more precision to the surgical procedure.
• The use of advanced vessel-sealing devices to reduce blood loss.
• The increasing focus on fertility preserving surgical techniques.
• Implementation of Enhanced Recovery After Surgery (ERAS) protocols, which help patients to heal faster and be discharged from hospital earlier.

Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) is a very effective minimally-invasive surgical technique for women who need a hysterectomy due to any of a number of gynaecological issues.

Laparoscopic visualization and vaginal removal of the uterus make LAVH more beneficial than other surgical options, including a reduction in pain, the presence of smaller scars, hospital stay is shorter, and recovery is much quicker.

Treatment should be tailored to each woman individual symptoms, and if she has a large number of gynaecological symptoms, she should speak with a gynaecologist in her area to find out if LAVH might be a suitable treatment.