A comparative study between laparoscopically assisted vaginal hysterectomy and vaginal hysterectomy: Experience in a tertiary diabetes care hospital in Bangladesh

Abstract

Objective:The study was undertaken to compare the efficiency and outcome of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and Vaginal Hysterectomy (VH) in terms of operative time, cost, estimated blood loss, hospital stay, quantity of analgesia use, intra- and postoperative complication rates and patients recovery.Materials and Methods:A total of 500 diabetic patients were prospectively collected in the study period from January 2005 through January 2009. The performance of LAVH was compared with that of VH, in a tertiary care hospital. The procedures were performed by the same surgeon.Results:There was no significant difference in terms of age, parity, body weight or uterine weight. The mean estimated blood loss in LAVH was significantly lower when compared with the VH group (126.5±39.8 ml and 100±32.8 ml), respectively. As to postoperative pain, less diclofenac was required in the LAVH group compared to the VH group (70.38±13.45 mg and 75.18±16.45 mg), respectively.Conclusions:LAVH, is clinically and economically comparable to VH, with patient benefits of less estimated blood loss, lower quantity of analgesia use, lower rate of intra- and postoperative complications, less postoperative pain, rapid patient recovery, and shorter hospital stay.

LAVH or TAH - choosing it wise and making it safe

“…Nevertheless this bearing on cost could be overcome by early return to work after LAVH. 10 Main drawbacks of our study were less number of cases who underwent LAVH and retrospective nature of the study.…”

“…Similar to the other studies we compared with, our study too showed that none of the patients following LAVH needed additional analgesics. Whereas 10.1% (10) patients following TAH required additional analgesics. 5 Average fall in haemoglobin concentration was 1.05 gm% in TAH group and 0.95gm% in LAVH group which was comparable.…”

Hospital Acquired Infections in Low and Middle Income Countries: Root Cause Analysis and the Development of Infection Control Practices in Bangladesh

“…Reduction in surgical site infections is associated with minimally invasive surgeries. A review of laparoscopically assisted vaginal hysterectomy and vaginal hysterectomies at a tertiary diabetes hospital in Bangladesh showed an average febrile morbidity of 1.6% and urinary tract infections of 1.2%, which is considerably lower than that for laparotomy cases [19].…”

A comparative analysis of nondescent vaginal hysterectomy, laparoscopy-assisted vaginal hysterectomy, and total laparoscopic hysterectomy for benign uterine diseases at a rural tertiary care center

“…[ 4 ] Studies have suggested that the benefit of minimally invasive surgeries over abdominal hysterectomy is in terms of acceptability and less duration of hospital stay and early resumption of work, but these surgeries need special skills that can be developed with time. [ 4 5 ] NDVH has the advantage of being scarless as compared to TLH and LAVH whereas it is not suitable for removing large size uterus. [ 6 ] LAVH and TLH have an advantage over NDVH because significantly large-size uterus can be removed without a large abdominal incision in the presence of pelvic pathology, adnexal mass, adhesions, and endometriosis by a skilled surgeon.…”

“…[ 4 ] Laparoscopic hysterectomies take increased operating time and increased rate of intraoperative complications, so lack of expertise and inexperience has a major impact in choosing the route of surgery. [ 5 ] This study was done to compare the feasibility of the different methods of hysterectomies for treatment of benign uterine disease in our rural tertiary care to find out the most effective, safe, feasible method in terms of operative time, amount of blood loss, hospital stay, amount of analgesic required on the 1 st postoperative day of surgery, intra- and postoperative complications rate, and postoperative duration of hospital stay.…”