LAVH better than minilaparotomy hysterectomy

Even though laparoscopic-assisted vaginal hysterectomy (LAVH) takes longer to perform than minilaparotomy hysterectomy, it's preferable when the vaginal approach cannot be used because it seems to cause less postoperative pain and fewer complications, according to the results of a small prospective, randomized, multicenter study from Italy.

Researchers studied 81 women with benign gynecologic disease who were candidates for abdominal hysterectomy and who had one or more contraindications to performing the procedure via the vaginal route.

Of the 41 women who received minilaparotomy, one required two units of red blood cell transfusion, which delayed the procedure; two developed surgical wound infections; and three developed fever of unknown origin, whereas no minor or major complications developed in the 40 women in the LAVH group (P=0.026).

The authors of the study concluded that minilaparotomy should be considered when laparoscopy is contraindicated.

Muzii L, Basile S, Zupi E, et al. Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study. J Minim Invasive Gynecol. 2007;14:610-615.