INTRODUCTION OF LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY IN A PRIVATE TEACHING COMMUNITY-HOSPITAL

Study Objective. To compare laparoscopically assisted vaginal hysterectomy (LAVH) with traditional total abdominal hysterectomy (TAH) when the laparoscopic approach is introduced into a private hospital. Design. During 7 year, 49 LAVHs were performed and compared with 51 consecutive TAHs using retrospective chart review and statistical analysis. Setting. A private, university-affiliated, teaching hospital. Patients. All patients undergoing LA VH, and the first 51 TAHs performed during the study year. Measurements and Main Results. No major complications occurred in either group. Significant differences were observed in uterine weight (161 +/- 92 g vs 331 +/- 354 g), operating time (164 +/- 48 min vs 108 +/- 28 min), and hospital stay (2.93 +/- 1.21 days vs 4.00 +/- 1.54 days) for LAVH and TAH, respectively. Hospital charges for LA VH averaged $4074 more than for TAH, primarily due to the use of disposable laparoscopic equipment. Conclusions. Laparoscopically assisted vaginal hysterectomy may be performed safely in a private community hospital with appropriate surgeon credentialing and training. Modifying techniques to minimize the use of disposable equipment would make the procedure more cost effective.