A Scottish audit of laparoscopically assisted vaginal hysterectomy

Objective To evaluate the use of laparoscopically assisted vaginal hysterectomy (LAVH) by a cross-section of gynaecologists in Scotland. Design A prospective registration of cases of LAVH carried out by gynaecologists. Case-note review was also performed in selected hospitals. Setting 13 hospitals in seven Scottish Health Boards. Subjects Women undergoing an LAVH. Results 505 LAVHs were reported between April 1994 and March 1996. Of these, 463 (91.7%) were successfully carried out laparoscopically. The uptake of laparoscopic surgery in Scotland overall is low, with a handful of surgeons performing the majority of procedures. Patient satisfaction with the procedure was high. Complication rates were high at 18.2% but this was mostly on account of postoperative infection. Only 34% of surgeons had any formal training in laparoscopic techniques, but this had increased to 55% by the end of the audit. Conclusions Complication rates in the present study were higher than those reported by expert laparoscopic surgeons, but perhaps reflect more accurately those expected from a cross-section of gynaecologists in current practice.