ROLE OF LAPAROSCOPIC ASSISTED VAGINAL HYSTERECTOMY IN GYNECOLOGY

One hundred and thirty laparoscopic assisted vaginal hysterectomies (L AVH) were performed at Chang Gung Memorial Hospital, All hysterectomie s were for indications of the uterus, endometriosis, and extensive adh esions, Some of the patients also underwent concomitant procedures inc luding unilateral or bilateral salping-oophorectomy, vaporization and/ or excision of endometriosis, lysis and/or excision of adhesions, Klep pinger bipolar forceps were used for large vessel hemostasis and excis ion of adhesions in all the patients, CO2 laser was used for vaporizat ion and excision of endometriosis, The complication rate was 10.0%. Th is included febric morbidity, intraoperative bladder injury, partial s mall bowel obstructions and thermal injury of the sigmoid colon, Four patients required laparotomy either to complete the procedure or to ma nage the complications, The mean blood loss was 160 ml and the mean ho spital stay was 2.2 days, The mean operating time was 148 minutes and the mean age of the patients was 42.3 years, Two weeks after surgery, the majority of the patients were permitted to drive and resume normal non-strenuous physical activity, The majority of the surgeries were v ideotaped, The study demonstrates that a hysterectomy can be safely pe rformed laparoscopically by the well trained laparoscopic surgeon, res ulted in reduced surgical morbidity, blood loss, postoperative discomf ort and pain, shortened hospital stay and recovery.