This is a Video Lecture of Laparoscopic Assisted Vaginal Hysterectomy by Dr. R.K. Mishra. Laparoscopically assisted vaginal hysterectomy (LAVH) is a minimal access surgical procedure using a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina. A vaginal hysterectomy is a surgery to remove the uterus through the vagina. It is a way to take the uterus out through a cut in the vagina instead of a cut in your belly. The ovaries or fallopian tubes (other female organs) may also be removed when the uterus is removed.


Laparoscopic Assisted Vaginal Hysterectomy (LAVH) is a minimally invasive surgical procedure used to remove the uterus through the vagina with the help of laparoscopic instruments.
 
During the LAVH procedure, a small incision is made in the belly button, and a laparoscope (a thin, lighted tube with a camera) is inserted. The surgeon can then see the uterus, ovaries, and other structures on a video screen. Additional small incisions are made in the lower abdomen to insert surgical instruments.
 
The surgeon then detaches the uterus from the surrounding ligaments, blood vessels, and tissues, using the laparoscope and other surgical instruments. The uterus is then removed through the vagina.
 
LAVH is considered a safe and effective alternative to traditional open hysterectomy, which requires a larger abdominal incision. The benefits of LAVH include less pain, smaller incisions, shorter hospital stay, faster recovery time, and fewer complications. However, it may not be suitable for all patients, and the decision to undergo LAVH should be made in consultation with a qualified healthcare provider.

Laparoscopic Assisted Vaginal Hysterectomy (LAVH) offers several advantages over traditional open hysterectomy. These include:
 
Less Pain:
LAVH is a minimally invasive procedure that involves smaller incisions, resulting in less pain and discomfort than traditional open surgery.

Smaller Incisions:
LAVH involves making only a few small incisions in the abdomen, which reduces scarring and promotes faster healing.

Shorter Hospital Stay:
Patients who undergo LAVH typically spend less time in the hospital than those who have traditional open surgery.

Faster Recovery:
Patients who undergo LAVH can often resume normal activities more quickly than those who have traditional open surgery.

Lower Risk of Infection:
LAVH involves less tissue trauma than traditional open surgery, which reduces the risk of infection.

Better Cosmesis:
The smaller incisions and reduced scarring associated with LAVH can result in better cosmetic outcomes.

Reduced Blood Loss:
LAVH is associated with reduced blood loss compared to traditional open surgery, which can be especially beneficial for patients who are at risk of complications related to blood loss.

Better Visualization:
The use of laparoscopic instruments in LAVH provides the surgeon with a better view of the internal organs, allowing for more precise surgical techniques.

Preservation of Ovaries:
In some cases, LAVH can allow for the preservation of one or both ovaries, which can help to maintain hormone balance and avoid menopause.

Lower Risk of Adhesions:
LAVH is associated with a lower risk of adhesions, which are bands of scar tissue that can form after surgery and cause pain and other complications.

Lower Risk of Hernias:
Because LAVH involves smaller incisions and less tissue trauma, it is associated with a lower risk of hernias, which occur when internal organs protrude through a weakened area of the abdominal wall.

Fewer Complications:
LAVH is associated with fewer complications than traditional open surgery, including a lower risk of infection, blood clots, and other surgical complications.

Improved Quality of Life:
Many women report improved quality of life following LAVH, including a reduction in symptoms such as heavy bleeding, pelvic pain, and discomfort during sex.

Shorter Recovery Time:
Compared to traditional open surgery, LAVH typically results in a shorter recovery time, allowing patients to return to their normal activities more quickly.

Less Scarring:
Because LAVH involves smaller incisions than traditional open surgery, it can result in less scarring and a better cosmetic outcome.

Overall, LAVH is a safe and effective alternative to traditional open surgery for the removal of the uterus. It offers several advantages, including less pain, smaller incisions, shorter hospital stay, faster recovery time, and fewer complications. However, it is important to discuss the potential risks and benefits with a qualified healthcare provider before deciding if LAVH is right for you.

Like any surgical procedure, Laparoscopic Assisted Vaginal Hysterectomy (LAVH) can have potential complications. Some of the common complications associated with LAVH include:
 
Bleeding:
LAVH can cause bleeding, which can be managed by the surgeon during the procedure or through medication after the procedure.

Infection:
Any surgical procedure has a risk of infection. Patients are typically given antibiotics before, during, and after the procedure to reduce this risk.

Organ Injury:
During the LAVH procedure, there is a risk of injury to nearby organs such as the bladder, ureters, or intestines. In rare cases, this can require additional surgery to repair the injury.

Anesthesia Complications:
Patients undergoing LAVH are placed under general anesthesia, which can cause complications such as nausea, vomiting, and respiratory problems.

Blood Clots:
Surgery can increase the risk of blood clots, which can be prevented with medication and early mobilization.
Urinary Problems: Some patients may experience difficulty urinating after LAVH due to swelling or injury to the bladder or ureters. This can usually be managed with medication or a temporary catheter.

Vaginal Vault Prolapse:
In some cases, removal of the uterus can cause the top of the vagina to sag or prolapse, which may require additional surgery.

Pain:
Although LAVH is a minimally invasive procedure, some patients may experience pain or discomfort after the procedure. Pain medication can help manage this discomfort.

Scarring:
While LAVH is associated with smaller incisions and reduced scarring compared to traditional open surgery, there is still a risk of scarring at the incision sites.

Conversion to Open Surgery: In some cases, LAVH may need to be converted to traditional open surgery due to unforeseen complications or difficulties during the procedure.

Adhesions:
Adhesions are bands of scar tissue that can form after surgery and can cause pain and other complications. While LAVH is associated with a lower risk of adhesions compared to traditional open surgery, they can still occur.

Sexual Dysfunction:
Some patients may experience sexual dysfunction after LAVH, such as decreased libido or difficulty with orgasm. These symptoms are usually temporary and improve over time.

Anesthesia Allergy: I
n rare cases, patients may experience an allergic reaction to the anesthesia used during LAVH. This can cause symptoms such as hives, difficulty breathing, or low blood pressure.

Bowel Problems:
Surgery can sometimes cause constipation or other bowel problems. These can often be managed with medication or changes to the patient's diet.

While the potential complications of LAVH can be concerning, it is important to remember that the risks are generally low and the benefits often outweigh the risks. Your healthcare provider can help you understand the potential risks and benefits of LAVH and make an informed decision about your healthcare.