LAPAROVAGINAL HYSTERECTOMY

The technique and complications of 141 patients having laparovaginal h ysterectomy in private practice are reported. Abdominal hysterectomy w as avoided in the 110 patients having preliminary laparoscopic surgery for pelvic disease, ovarian removal, or a uterus larger than 12cm. Po stoperative morbidity included pulmonary embolus (3), vesicovaginal fi stula (2) and pelvic haematoma (4). The frequency of complications was less than that reported after abdominal or vaginal hysterectomy. The surgical technique changed during the series; the operative care of th e bladder and ureter requires particular attention. A larger number of patients in a variety of centres require study before the laparoscopi c procedure can be determined to be as safe as abdominal or vaginal hy sterectomy. The laparoscopic procedure has the potential to replace th e majority of abdominal hysterectomies.