A Scottish audit of laparoscopically assisted vaginal hysterectomy

Objective To evaluate the use of laparoscopically assisted vaginal hysterec tomy (LAVH) by a cross-section of gynaecologists in Scotland. Design A prospective registration of cases of LAVH carried out by gynaecolo gists. Case-note review was also performed in selected hospitals. Setting 13 hospitals in seven Scottish Health Boards. Subjects Women undergoing an LAVH. Results 505 LAVHs were reported between April 1994 and March 1996. Of these , 463 (91.7%) were successfully carried out laparoscopically. The uptake of laparoscopic surgery in Scotland overall is low, with a handful of surgeon s performing the majority of procedures. Patient satisfaction with the proc edure was high. Complication rates were high at 18.2% but this was mostly o n account of postoperative infection. Only 34% of surgeons had any formal t raining in laparoscopic techniques, but this had increased to 55% by the en d of the audit. Conclusions Complication rates in the present study were higher than those reported by expert laparoscopic surgeons, but perhaps reflect more accurate ly those expected from a cross-section of gynaecologists in current practic e.