What Is Laparoscopic Assisted Vaginal Hysterectomy (LAVH) Surgery?
A Laparoscopic Assisted Vaginal Hysterectomy (LAVH) is a surgical procedure where the uterus is removed using both laparoscopic and vaginal approaches. This approach combines the benefits of minimally invasive laparoscopic surgery with the advantages of traditional vaginal surgery, leading to reduced pain, shorter recovery time, and smaller incisions compared to traditional open abdominal hysterectomy.
2-3 Hours
Surgery Duration
General Anesthesia
Anesthesia Used
4-6 Weeks
Full Recovery Timeline
Indications of Laparoscopic Assisted Vaginal Hysterectomy Procedure
Indications of Laparoscopic Assisted Vaginal Hysterectomy usually arise when other treatments are not effective in managing gynecological conditions. The procedure is recommended in cases such as:
- Uterine Fibroids: Uterine fibroids are benign tumors that may lead to heavy periods, pelvic pain, and pressure on surrounding organs.
- Endometriosis: A condition called endometriosis, where tissue resembling the lining of the uterus grows outside the uterus, causing pain and other symptoms.
- Adenomyosis: A condition where the uterine lining grows into the muscular wall of the uterus, leading to pain, heavy bleeding, and an enlarged uterus.
- Uterine Prolapse: When the uterus descends into the vaginal canal due to weakened pelvic support.
- Abnormal Uterine Bleeding: When other treatment options for heavy or abnormal uterine bleeding have been unsuccessful, a hysterectomy may be considered, and LAVH can be a minimally invasive approach to address this issue.
- Pelvic Pain: Chronic pelvic pain that is unresponsive to other treatments or is caused by gynecological conditions may warrant a hysterectomy, and LAVH can be an option.
- Pre-cancerous or Cancerous Conditions: In some cases, a hysterectomy may be recommended for pre-cancerous conditions (e.g., severe cervical dysplasia) or early-stage uterine or cervical cancer. The surgical approach chosen depends on the extent of the disease and other factors.
It's essential to talk to your doctor to find the best treatment plan tailored to your health, symptoms, and personal preferences.
In some cases, alternative surgical approaches, such as total laparoscopic hysterectomy or robotic-assisted procedures, may also be considered.
The expertise of the surgical team and the availability of specialized equipment can influence the choice of surgical approach.
Preparing for Laparoscopic Assisted Vaginal Hysterectomy Procedure
Preparing for a Laparoscopic Assisted Vaginal Hysterectomy (LAVH) involves both medical and practical preparations to ensure the procedure goes smoothly and the recovery is as comfortable as possible.
Here's a general guideline for preparing for the LAVH procedure:
- Consultation with Your Gynecologist: Have a detailed discussion with your gynecologist before the surgery. This appointment will cover the procedure, your medical history, current medications, and any specific instructions related to your health.
- Medical Tests: Your doctor may recommend blood tests, imaging tests (such as an ultrasound or MRI), and a physical exam to assess your overall health and confirm that you are fit for surgery.
- Review Medications: You may need to stop taking certain medications, such as blood thinners, a few days before the procedure. Always follow your doctor's instructions.
- Follow Fasting Instructions: You'll be asked not to eat or drink anything for a certain time before surgery, usually starting at midnight the night before. Your doctor will give you clear instructions.
- Arrange for Transportation: You'll need someone to drive you to and from the hospital on the day of the surgery, as the effects of anesthesia will require you to avoid driving.
- Hospital Bag: Bring along comfortable clothes, basic toiletries, any regular medications, and something to read or keep you entertained during your hospital stay.
- Follow Pre-Op Instructions: Your gynecologist will provide detailed pre-operative instructions, which may include bathing with a special soap, avoiding certain skin products, and not eating or drinking after a specific time. Follow these instructions carefully.
- Support System: Inform your family or a close friend about your surgery and the recovery period you expect. Having someone to assist you during the initial recovery at home is essential.
Steps Involved in Laparoscopic-Assisted Vaginal Hysterectomy Procedure
During a Laparoscopically Assisted Vaginal Hysterectomy (LAVH), the surgeon uses a combination of laparoscopic techniques and vaginal surgery to remove the uterus.
Here's a step-by-step breakdown of the laparoscopically assisted vaginal hysterectomy procedure:
- Anesthesia: The patient is given general anesthesia to ensure they are unconscious and do not feel any pain during the surgery. The surgical team prepares the patient by cleansing and sterilizing the abdominal and vaginal areas.
- Insertion of Trocars: Small incisions (usually 0.5 to 1 cm) are made in the abdomen to insert trocars or ports. These ports allow for the laparoscope, a thin, illuminated tube with a camera, and other surgical instruments to access the area.
- Laparoscopic Examination: Using a tiny camera, the surgeon carefully views the internal organs on a screen.
- Detachment of Uterus: Using special instruments, the surgeon gently separates the uterus from the surrounding tissues, blood vessels, and ligaments. All of this is done carefully through the small cuts in your abdomen.
- Vaginal Removal: The uterus is then removed through the vaginal opening.
- Closing the Incisions: The small abdominal incisions used for the trocars are closed, usually with absorbable sutures or surgical adhesive.
- Recovery: After surgery, you'll be taken to a recovery room where nurses will monitor you as you wake up. Pain relief and aftercare instructions will be provided before you go home or move to a hospital room.
Who will Perform Laparoscopic Assisted Vaginal Hysterectomy Procedure?
Laparoscopic Assisted Vaginal Hysterectomy" (LAVH) is a surgical procedure performed by a gynecologist, specifically a gynecologic surgeon. Gynecologic surgeons are medical doctors who specialize in diagnosing and treating conditions related to the female reproductive system.
When a patient is a candidate for LAVH, the gynecologist will assess the specific medical condition, the patient's overall health, and other relevant factors to determine if LAVH is the appropriate treatment option. The gynecologic surgeon will then perform the surgery, often in collaboration with a surgical team that may include anesthesiologists, nurses, and other healthcare professionals.
Recovery after Laparoscopic Assisted Vaginal Hysterectomy Procedure
Recovery after lap vag hysterectomy Varies from person to person, but generally, it is less extensive compared to traditional open abdominal hysterectomy.
Here are some key aspects of the recovery process:
- Hospital Stay: Most people go home the same day or after 1 to 2 days, depending on how they are feeling.
- Pain Management: Some pain or discomfort is normal after surgery. Your doctor will give you medicine to help manage it. Take it as directed and let your doctor know if it doesn't work.
- Vaginal Bleeding: Some vaginal bleeding or discharge is normal after the surgery. Use pads, not tampons, as needed, and report any heavy or prolonged bleeding to your healthcare provider.
- Rest and Movement: It's important to rest, but gentle walking is encouraged soon after surgery to promote healing and prevent blood clots.
- Follow-Up Appointments: You'll have follow-up appointments to check your healing. Don't skip them.
- Return to Normal Activities: Most people feel ready to return to normal activities in 2 to 6 weeks. Avoid sex, heavy lifting, or tough workouts until your doctor says it's safe.
- Resuming Work: When you return to work, it depends on your job and the rate of your recovery. Desk jobs may be okay in a couple of weeks; more physical jobs might take longer.
Lifestyle Changes after Laparoscopic Assisted Vaginal Hysterectomy Procedure
After undergoing a Laparoscopic Assisted Vaginal Hysterectomy (LAVH), there may be some lifestyle changes to consider during the recovery period and beyond.
Here are some potential lifestyle changes to keep in mind:
- Rest and Recovery: Take time to rest and recover. Avoid any heavy work or intense activities until your doctor gives you the okay.
- Physical Activity: Start with light walking and gradually return to your usual routine. Don't lift heavy things or do hard exercises too soon.
- Diet: Eat a balanced diet that includes fruits, vegetables, protein, and fiber. Drink plenty of water to stay hydrated and help your body heal.
- Pelvic Floor Exercises: Your doctor may recommend simple exercises, like Kegels, to strengthen the muscles in your lower body.
- Watch for Symptoms: Report unusual pain, fever, or heavy bleeding to your doctor.
- Hormone Replacement Therapy (HRT): Depending on why you had the surgery, your doctor might talk to you about hormone replacement therapy (HRT). Follow their advice if it's needed.
- Stress Management: Try to stay relaxed with things like deep breathing, meditation, or gentle yoga. Staying calm can help you heal better.
- Regular Check-ups: Even if you no longer have a uterus, continue to get regular check-ups to stay healthy.
Benefits of LAVH Surgery
Laparoscopic Assisted Vaginal Hysterectomy (LAVH) offers a modern, minimally invasive approach to hysterectomy, providing patients with several advantages over traditional open surgery.
- Minimally Invasive: The surgery uses tiny cuts, which means smaller scars and a lower chance of infection.
- Faster Recovery: Most patients can return to normal activities much quicker compared to traditional open surgery.
- Less Pain: Since there's no big cut on the belly, there's usually less pain afterward.
- Shorter Hospital Stay: Many patients can go home within 1 to 2 days after surgery.
- Less blood loss: Reduced risk of needing a blood transfusion
- Cosmetic Advantage: The small cuts are hardly noticeable once healed, leaving minimal marks on the skin.
Possible Complications of LAVH Surgery
Like any surgical procedure, Laparoscopic Assisted Vaginal Hysterectomy (LAVH) surgery carries potential risks and complications. Being aware of these helps patients understand what to watch for and take preventive measures during recovery.
- Infections
- Bleeding
- Injury to Other Organs
- Blood Clots
- Anesthesia-related issues
- Trouble Urinating
- Hernia
- Vaginal Prolapse
- Emotional impact after surgery
LAVH (Laparoscopically Assisted Vaginal Hysterectomy) surgery cost in India
- In Tier-1 cities across India, the cost generally ranges between Rs. 98,000 to Rs. 1,22,000. This typically includes hospital stay, surgeon and operative fees, anesthesia, and basic pre-op labs.
- For instance, one estimate places the average LAVH cost around Rs. 1,21,000.
These prices can vary based on city, hospital facilities, insurance coverage, and complexity of the surgery.
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