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Laparoscopically Assisted Vaginal Hysterectomy

Laparoscopically Assisted Vaginal Hysterectomy (LAVH) is a procedure using laparoscopic surgical techniques and instruments to remove the uterus (womb) and/or tubes and ovaries through the vagina.

Its greatest benefit is the potential to convert what would have been an abdominal hysterectomy into a vaginal hysterectomy. An abdominal hysterectomy requires both a vaginal incision and a four to six inch long incision in the abdomen, which is associated with greater post-operative discomfort and a longer recovery period than for a vaginal procedure. Another advantage of the LAVH may be the removal of the tubes and ovaries which on occasion may not be easily removed with a vaginal hysterectomy.

This does not mean that all hysterectomies could or should be done by LAVH. There are certain conditions that will necessitate abdominal or vaginal hysterectomy. In fact a vaginal hysterectomy by itself, if indicated, is less time consuming, less expensive, and can be less dangerous. When LAVH is performed, several small abdominal incisions are made. Through these small incisions slender metal tubes known as “trocars” are inserted. They provide passage for a laparoscope (which is like a tiny telescope) and other microsurgical tools.

A camera attached to the laparoscope provides a continuous image that is magnified and projected onto a television screen. It provides the view by which the surgeon operates.

The uterus is detached from the ligaments that attach it to other pelvic structures using laparoscopic tools, electro-coagulation or a laser. Adhesions may have to be freed and, if the tubes and ovaries are to be removed, they are detached from their ligaments and blood supply. They then can be removed with the uterus through an incision made in the vagina. Since the incisions are small, the scarring and pain from LAVH is often less than that associated with abdominal hysterectomy.

This approach is best for benign conditions that lead to hysterectomy when the uterus is not too large. It is often the best approach for uterine prolapse. With a vaginal hysterectomy, you will not have any external scarring. You may also recover more quickly because you are not waiting for a large abdominal incision to heal.

However, vaginal hysterectomy gives the surgeon less room to operate and no real opportunity to view your pelvic organs.

Laparoscopically assisted vaginal hysterectomy offers an alternative. It is a combined procedure that can remove the uterus vaginally when it otherwise would require a large abdominal incision. The surgeon makes a small incision in your lower abdomen to insert a thin device (laparoscope) that allows the surgical team to see inside your abdomen. Your surgeon uses specially crafted surgical instruments to detach the uterus and then removes it through your vagina. This approach requires the longest operating time.

This Post Has 74 Comments
  1. I’m 65 and will have a hysterectomy on 11 April, with ovaries and uterus removed. I went through menopause at 58 with no problem at all and have never had HRT. I have a cyst growing on one of my ovaries and my elderly mum had ovarian cancer diagnosed just before she passed away at 84, so this is a precautionary operation.
    A friend suggested I would need HRT after having ovaries removed but I didn’t think I would. Does anyone know the answer? I will check with my doctor when I go in to hospital but it would be good if anyone knows the answer.

  2. Hi, I am 33yrs old and has a lavh with removal of some endo, uterus, cervix, and tubes. I got to keep my ovaries. I am 3 weeks out from surgery now and I have a uti now, I’m pretty sure I’ve had it for a couple weeks but was just started on antibiotics. My doc told me that I can’t do anything really no sweeping, mopping, vacuum, dishes, picking up my kids, bending over, and limit my stairs for a total of 6 wks. I was told this at my 2 wk check up. Anybody else get the same restrictions for 6 wks? I’m going crazy as I’m a stay at home mom…it’s making me feel worthless :(. I feel fine really, I just walk really slow still. I’m not really in any pain. Of course I’m going to listen to her orders, because I don’t want to wind up back in the hospital. I just thought I would be back to my routine at 2 wks not 6.

  3. I had a LAVH done 19/8/16 and felt I was recovering well until day 10, woken up with stabbing pain & heavy bleeding. Same thing happened the following week. Saw my consultant last night who says its haematoma & all ok but wish someone had told me this could happen – very scary. Dont see how anyone could go back to work after one week, I get so tired!

  4. Hello Ladies,
    I am a 48 year old tennis coach and middle school teacher. I am having a LAVH in a month. I am having the surgery on a Tuesday and thought I would be back teaching and coaching by the next week. I am told that is dreaming…has anyone had success with going back to normal routine and work activities sooner than 4-6 weeks?
    I’m feeling discouraged.
    However, I’m thinking anything is better than the bleeding and resulting anemia that I am having now. Is it true that I will feel that much better after recovery?????

    1. Hi Connie, yes, I was back at work after week. My LAVH surgery was done on Monday 25.4. and following Monday I started to work again. So far I am feeling really good, even better than I expected.

    2. I had mine (lavh procedure) less than a week ago and I have been up and about since my 2nd day home. I have had zero pain and have not taken any pain meds. I have to stop myself from lifting things b cause I was told to take it easy, but I’ve been so well I keep forgetting! I want to go back to work and ride my horse, I have to force myself not to!

    3. Today I am 2 weeks post LAVH. I am off pain meds except for NSAIDS. I am very glad I have a full 4 weeks off as I still walk slowly and have no stamina. Bowel functions ok but that took a full week. Did not take any laxatives, only Colace. I am off that now. Good luck!

    4. Hi I’m Theresa my lvah was 2 weeks ago I’ve been up walking around the day after surgery my bowel movements hurt at first but put thar down to the pain meds I am sooooooo bored at home I’d be back at work tomorrow if I could but I’m a supervisor in house of fraser so on my feet all day even though I’m building the walking distance I do every day my tummy pulls abit if I do to much walking my partner frustrates me as he won’t let me pick nothing up but the surgeon told me I could but just be careful your body will tell you what not to do at least I’m catching up with TV I’ve recorded xx food luck ladies best decision I ever made I had everything removed tubes ovaries and uterus

    5. Hi Theresa have just read your post I’m waiting for appointment to have vaginal hysterectomy some of the posts I have read has made me a bit more nervous but I read yours and it has given me a bit more hope I lost my husband 5 years ago to cancer he was 66 this summer about April I had a breakdown it all hit me at once I didn’t want to live but my doctor got me urgent councelling and I feel a lot better I have even been abroad this so temper I lost my mum 2 years ago and my dad 6 months b4 my husband Stuart so anything that happens to me or worries I can’t cope easy how long was you in hospital after op glad yr ok now take care and have a lovely xmas from jan x ☺?

  5. I had a LAVH not even a week ago and I wish to return back to work on monday which will be just under 2 wks recovery and I work in an office sitting all day, thats not to early is it??

  6. I HAD MY LAHV ON NOVEMBER 6. I’M FEELING OK, BUT TODAY I WAS CLEANING MY BELLY BUTTON AND I HAD SOME BRIGHT RED BLOOD ON THE Q-TIP. I’M STILL HAVING SOME LEAKAGE AND FOWL SMELL COMING FROM VAGINA. IS THIS NORMAL?

  7. Hi had a hysterectomy just shy of 6 weeks ago. It was done with a fancy robot, vaginally. I thought for sure when I was given the recovery time of 4-8 weeks the Dr was joking. Thought for sure I’d be up and moving in 2 weeks because “I’m not a pansy” – calm down, it’s a joke I have for family and friends when I hurt myself and need to get back to work….but I found recovery to be so much more than I expected. You had major surgery! Things are no longer there that have always been there. Have you watched any type of surgery – it’s not gentle. Your insides were moved around with the intent of moving them around to do said surgery and not for comfort – yes they don’t want to nick or poke or cut or hurt anything – but there is a time limit and those other things need to get out of the way. That is a lot of the pain you guys are feeling. You lost major organs and your other organs are trying to make themselves a new home. I spent last week – week 5 – dry heavy every day like I had morning sickness. This is a thing. I hope that isn’t going to happen again. Bad pain, bleeding, light headedness, being super tired, moody, not able to eat a lot. I wasn’t really told this was shit that would or could happen but it does and it has. I still have my ovaries, but menopause can still happen folks. We’ll all be good. I promise! The reason we had this surgery done was far crappier than where we are heading.

    1. I had a Laparoscopic hysterectomy done on the 15 august 2016 and they left my ovaries in I feel the pain getting bad and I am hot and my scars are red and I wish I could feel back to know again as I can not work as well at the moment

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