A Comparative Study between Laparoscopically Assisted Vaginal Hysterectomy and Abdominal Hysterectomy
Prasong Jaturasrivilai MD*
Affiliation : * Department of Obstetrics and Gynecology, Uttaradit Hospital, Uttaradit
Objective : To compare efficiency of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdomi-
nal hysterectomy (TAH)
Materials and Methods : Medical records of 50 cases of LAVH and 50 cases of TAH were reviewed from January
2004 to December 2004
Results : There was no significant difference between the two groups in basic clinical characteristics. Myoma
uteri was the major cause of operation. The operative time (115.9 + 40.8 min vs. 68.2 +14.2 min), the operative
cost (26,763.48 + 2,718.37 Baht vs. 22,345.50 + 4,057.40 Baht), diclofenac for postoperative analgesics
(135.0 + 67.5 mg vs. 300.0 + 75.0 mg), the postoperative hospital stay (2.6 + 0.9 days vs. 4.5 + 1.1 days), and
the time to return to work (30.4 + 3.1 days vs. 50.9 + 6.6 days) were significantly different in the LAVH group
compared to the TAH group. There was no significant difference in blood loss between the two groups. The
mean score of recovery scale for LAVH was 9 and 7 for TAH at the 28th day of post-op. There was one bladder
injury in the LAVH group. The common complications in both groups were hemorrhage and febrile morbidity.
The learning curve of LAVH procedure showed that operative time was significantly different between the 30th
and 40th cases (122.0 + 31.8 min vs. 91.0 + 26.5 min). Doing LAVH with condition of uterine weight will not
effect the operative time and blood loss.
Conclusion : LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH.
Moreover, LAVH does not increase intra- or postoperative complications. LAVH is another alternative choice
to treat myoma uteri in a well trained operator.
Keywords : LAVH, TAH
