Laparoscopic Assisted Vaginal Hysterectomy

A laparoscopic assisted vaginal hysterectomy (LAVH) is a surgical procedure to remove the uterus and cervix, and sometimes the ovaries and fallopian tubes. During an LAVH, some of the surgical removal is done through the vagina and the rest is done through a few small surgical cuts (incisions) in the abdomen.

This procedure is usually considered in women when a vaginal hysterectomy (VH) is not an option. Your surgeon will discuss the risks and benefits of the different surgical techniques at your appointment. Symptoms such as chronic pelvic pain, pressure, and heavy or painful periods can be treated with an LAVH. Generally, recovery time is faster and there are fewer complications after laparoscopic procedures than after open incisional procedures.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy.

RISKS AND COMPLICATIONS

  • Allergies to medicines.

  • Difficulty breathing.

  • Bleeding.

  • Infection.

  • Damage to other structures near the uterus and cervix.

BEFORE THE PROCEDURE

  • Ask your caregiver about changing or stopping your regular medicines.

  • Take certain medicines, such as a colon emptying preparation, as directed.

  • Do not eat or drink anything for at least 8 hours before your surgery.

  • Take a shower at home the night before your procedure.

  • Arrive without jewelry, makeup, nail polish, or any lotions or deodorants.

  • Stop smoking if you smoke. Stopping will improve your health after surgery.

  • Arrange for a ride home after surgery and for help at home during recovery.

PROCEDURE  

  • An intravenous (IV) access tube will be put into one of your veins in order to give you fluids and medicines.

  • You will receive medicines to relax you and medicines that make you sleep (general anesthetic).

  • You may have a flexible tube (catheter) put into your bladder to drain urine.

  • You may have a tube put through your nose or mouth that goes into your stomach (nasogastric tube). The nasogastric tube removes digestive fluids and prevents you from feeling nauseous and vomiting.

  • Tight fitting (compression) stockings will be placed on your legs to promote circulation.

  • Three to four small incisions will be made in the abdomen. An incision is also made in the vagina. Probes and tools are inserted into the small incisions. The uterus and cervix are removed (and possibly your ovaries and fallopian tubes) through the vagina, as well as through the 3 to 4 small incisions that were made in the abdomen.

  • The vagina is then sewn back to normal.

  • The procedure takes about 1 to 3 hours.

AFTER THE PROCEDURE

  • Plan to be in the hospital for 1 to 2 days.

  • You may have abdominal cramping and a sore throat. Your pain will be controlled with medicine.

  • You may have a liquid diet temporarily. You will most likely return to, and tolerate, your usual diet the day after surgery.

  • You will be passing urine through a catheter. It will be removed the day after surgery.

  • Your temperature, breathing rate, heart rate, blood pressure, and oxygen level will be monitored regularly.

  • You will still wear compression stockings on your legs until you are able to move around.

  • You will use a special device or do breathing exercises to keep your lungs clear.

  • You will be encouraged to walk as soon as possible. 

  • Expect a full recovery in 4 to 6 weeks after surgery.