A multicenter review of 839 laparoscopic-assisted vaginal hysterectomies.

A multicenter review of 839 cases of laparoscopic-assisted vaginal hysterectomy (LAVH) was conducted to contribute to the clinical decision-making process regarding the procedure, which has been the subject of much debate in recent years. The results suggest that patients undergoing LAVH experience complication rates no higher than those having any other type of hysterectomy, and that efficacy is identical to that of vaginal hysterectomy. Furthermore, the laparoscopic approach affords better visualization of pelvic pathology and better adnexal access for the accomplishment of concurrent pelvic procedures. Mean hospital stay is 1.7 days and mean recovery time 20 days. The notion of a learning curve as described by diminishing procedure time and declining complication rates over time is not supported by this data set. Patients who may traditionally have faced abdominal hysterectomy due to putative or demonstrated pelvic pathology may benefit the most from LAVH.