LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY AS AN ALTERNATIVE TO ABDOMINAL HYSTERECTOMY IN PATIENTS WITH FIBROIDS

Objective: Introduction of laparoscopically assisted vaginal hysterect omy (LAVH) was evaluated for its usefulness to replace abdominal hyste rectomy in fibroids. Study design: A total of 240 women with a mean ag e of 46.7 years underwent hysterectomy over a period of one year. The technique of LAVH was introduced starting in the second quarter of the study period. Clinical data of 60 patients undergoing either LAVH or abdominal hysterectomy for fibroids were compared in a cross-sectional study by chi(2)- and t-test. Results: A comparison between the first and the last quarter of the study period showed that the rate of abdom inal hysterectomies decreased from 66% to 12%, whereas LAVH increased from 0 to 40% (p < 0.05). The rate of vaginal hysterectomies remained between 34% and 48%. Compared to abdominal hysterectomy, LAVH operatin g time was about 1/3 longer, hospital stay was shorter (3 days), and L AVH proved more cost-effective than abdominal hysterectomy (significan ce of all differences: p < 0.05). Conclusions: LAVH is a valid alterna tive to abdominal hysterectomy in fibroids.