Original articles

Implications of performing laproscopic assisted vaginal hysterectomy versus abdominal hysterectomy on suitable patients in a South African hospital setting

Andreas Chrysostomou

Abstract


Abstract
Objectives: 1) to compare short term clinical results with standard abdominal hysterectomy (AH); 2) to investigate the feasibility of registrar training in VH by laparoscopic assistance; 3) to investigate the impact of laparoscopy in changing the route of hysterectomy in women assessed as being unsuitable for VH on clinical examination. Methods: 104 women scheduled for AH for benign uterine conditions were enrolled in this study, meeting the following criteria: uterine size ≤14-week pregnancy, width ≤9cm and length ≤14cm. Clinical ovarian pathology and uterine prolapse were exclusion criteria. Patients were divided in 2 groups matched with respect to age, parity, previous pelvic surgery and indications for hysterectomy. Prior to VH laparoscopic assessment of pelvic organs was performed for 58 of the 104 patients in this study, 46 of these patients had abdominal hysterectomies without laparoscopic assessment.
Results: All cases allocated to have VH facilitated by laparoscopic assessment were successful. There was no need to convert to the abdominal route. Required time for LAVH compared to AH was longer, but not significantly so (mean 59.3 min. vs. 57.2 min.). Blood loss was found to be less with LAVH. Postoperative pain and need for analgesia was significantly less in LAVH as compared to AH (P<0.001). The postoperative hospital stay was significantly shorter in the LAVH group (2.4 days) as compared to AH (3.9 days); P<0.001.
Conclusion: There was shorter hospital stay, less need for analgesia, less intraoperative bleeding, and better patient satisfaction with LAVH. Moreover, it decreased the number of hysterectomies done abdominally.

Author's affiliations

Andreas Chrysostomou, Doctor

Full Text

PDF (729KB)

Keywords

Laparoscopy; Hysterectomy; Fibroids

Cite this article

South African Journal of Obstetrics and Gynaecology 2008;14(2):70.

Article History

Date submitted: 2007-12-03
Date published: 2008-10-30

Article Views

Abstract views: 5930
Full text views: 2789

Comments on this article

*Read our policy for posting comments here


The South African Medical Association is the official publisher of the SAJOG.

                                                           

                                        SOUTH AFRICAN MEDICAL ASSOCIATION

                                                         Events | Careers | CPD

 

The South African Journal of Obstetrics and Gynaecology| Online ISSN: 2305-8862 | Print ISSN: 0038-2329 | 

Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) | 

This journal is protected by a Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) | Read our privacy policy.

SAMA Journals: South African Medical Journal African Journal of Health Professions Education South African Journal of Bioethics and Law South African Journal of Child Health | Southern African Journal of Critical Care  | South African Journal of Obstetrics and Gynaecology | Undergraduate Research in Health African Journal of Thoracic and Critical Care Medicine  | Southern African Journal of Public Health