OUTPATIENT LAPAROSCOPIC-ASSISTED VAGINAL HYSTERECTOMY

Study Objective. To compare laparoscopic-assisted hysterectomy (LAVH) with conventional abdominal hysterectomy. Design. First 50 consecutive LA VH procedures. Setting. An outpatient facility at a major medical center (35 procedures) and a nonhospital free-standing surgi-center (15). Patients. Sequential sample of 50 women requiring hysterectomy. Interventions. LAVH in 46 women, converted to open laparotomy in 4. Measurements and Main Results. Outpatient LAVH was performed successfully in the majority of women. Most patients had significant uterine enlargement, pelvic adhesions, or endometriosis. Only six required replacement of autologous blood postoperatively. Other complications were cystotomy and postoperative pelvic hematoma in one patient each. Conclusions. LAVH can be performed safely in free-standing surgicenters. It offers several advantages to patients, and is considered cost effective by third-party payers.