Laparoscopically Assisted Vaginal Hysterectomy (LAVH) is a surgical procedure to remove the uterus through the vagina. If the need be, the surgeon also removes the Fallopian tubes and ovaries with the uterus. With the use of Laproscopic tools, this procedure disconnects the uterus from the ligaments that connect it to the other organs in the pelvis.
LAVH treats many gynecological ailments. The most common of these include:
- Benign Uterine Fibroid
- Abnormal Uterine Bleeding
- Genital Prolapse
- Chronic Pelvic Pain
- Uterine Cancer
Physicians treat most of these conditions, other than Uterine Cancers, with medication and less invasive surgical processes. Only if these processes fail, they recommend a LAVH.
After LAVH, the woman loses her fertility and she would never get pregnant. Hence, it is important to decide on the surgery after measuring the pros and cons.
LAVH – Advantages
When compared with Abdominal Hysterectomy and routine Vaginal Hysterectomy, LAVH has the following advantages:
- Incisions are small
- Recovery is faster
- Less traumatic physically
- Less postoperative pain
- Fewer postoperative infections
- Shortened hospitalization, takes less than 24 hours
LAVH – Disadvantages
When compared with routine Vaginal Hysterectomy, LAVH has the following disadvantages:
- Time taken for the surgery is longer
- More dangerous
- More expensive
- Surgical Complications include bleeding, bladder injury, nerve injury, intestinal injury, post operation infection and a few others
A Gynecologist or Obstetrician is the subject matter expert.
The LAVH Procedure
The LAVH procedure involves making several small incisions in the abdominal wall followed by insertion of Trocars or metal tubes which make room for the laparoscope and other microsurgical tools. The camera attached to the laparoscope gives a continuous image to help detach the uterus from the ligaments which connect it to the other organs in the pelvis.
If the need be, then the surgeon also detaches the Fallopian tubes and ovaries from their ligaments. Lastly, he removes all these organs through an incision made in the vagina.
Complication in Management
LAVH, like other surgeries has its own set of complications. Surgical Complications include heavy bleeding, bladder injury, nerve injury, intestinal injury, hemorrhage and post operation infection. Some patients may also experience damage to the surrounding organs and may have an adverse reaction to anesthesia.
These complications are more common with women suffering from Diabetes or High Blood Pressure. It is normal to have bloody vaginal discharge for several days to weeks, vaginal dryness, irritation, insomnia, weight gain, or hot flashes after a LAVH.
Precautions after Surgery
Recovery is fast and pain is less after LAVH. Full recovery takes about a month. The patient must follow the following precautions after undergoing the surgery:
- Do not lift heavy weight
- Do not bend too much
- Do not climb stairs
- Ask for painkillers if the pain is unbearable after the surgery
- To prevent Pneumonia, Blood Clot Formation and for a speedy recovery, get back to normal walking, under supervision of the physician
- To get relief from gastric pains try walking and performing deep breathing exercises slowly
- Hold a pillow over the surgical abdominal wound or cross legs to reduce coughing, if any. Coughs may cause pain in the wound
- Ovary removal may cause estrogen loss which leads to Osteoporosis or loss of bone density. Physicians usually suggest supplementary medications for this
- Sexual intercourse may resume 4 – 6 weeks after the surgery
Dietary and Physical Activity Requirements Post Surgery
It is important to eat healthy food and start walking within a day or two after the surgery, under medical supervision.
Support from Family
Some patients after the surgery feel relieved, as they get rid of troublesome symptoms, such as, heavy bleeding and pelvic pain. However, some may experience depression due to loss of fertility. This is especially true if the patient is young and wished to get pregnant. These patients need extra attention and care from the family members.