A vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina. This method is preferred at our hospital in Nagpur because it avoids the need for abdominal incisions, leading to a potentially quicker recovery and fewer complications.
Indications
- Uterine fibroids
- Endometriosis
- Uterine prolapse
- Chronic pelvic pain
- Abnormal uterine bleeding
- Gynecologic cancers (in select cases)
Procedure
Preparation
Preoperative assessments including
- blood tests
- imaging studies
- consultations
- Anesthesia: General or spinal anesthesia is administered.
Surgical Steps
- A speculum is inserted into the vagina to visualize the cervix.
- The uterus is detached from the surrounding structures including the fallopian tubes, ovaries (if not removed), and supporting ligaments.
- The uterus is removed through the vaginal canal.
- The vaginal incision is closed with sutures.
Postoperative Care
- Hospital stay typically ranges from 1 to 2 days.
- Recovery period: 4 to 6 weeks.
- Pain management with medications.
- Instructions on activity restrictions to aid in healing.
Advantages
- No visible scars on the abdomen.
- Shorter hospital stay and faster recovery.
- Less postoperative pain and lower risk of infection.
Disadvantages
- Limited access to the upper abdomen, making it challenging for complex cases.
Laparoscopically Assisted Vaginal Hysterectomy (LAVH)
LAVH combines laparoscopic techniques with vaginal hysterectomy. It involves the use of a laparoscope to assist in detaching the uterus before removal through the vagina, providing the best care for our patients.
Indications
Same as for vaginal hysterectomy, with the addition of cases where better visualization and access to the pelvic organs are needed.
Procedure
Preparation:
- Similar preoperative assessments as for vaginal hysterectomy.
- General anesthesia is commonly used.
Surgical Steps:
- Small incisions are made in the abdomen for the insertion of the laparoscope and surgical instruments.
- The laparoscope provides a view of the pelvic organs on a monitor.
- The uterus is detached laparoscopically from the upper structures (fallopian tubes, ovaries, etc.).
- The detached uterus is then removed through the vagina.
- Both abdominal and vaginal incisions are closed with sutures.
Postoperative Care
- Hospital stay and recovery period are similar to vaginal hysterectomy at our hospital in Nagpur.
- Additional care for abdominal incisions.
Advantages
- Combines the benefits of minimally invasive laparoscopic surgery with vaginal removal.
- Better visualization and access to the pelvic organs.
- Useful for more complex cases where a purely vaginal approach might be insufficient.
Disadvantages
- Requires additional laparoscopic skills and equipment.
- Slightly longer surgical time compared to vaginal hysterectomy alone.
Risks and Complications
- Infection
- Bleeding
- Injury to surrounding organs (bladder, intestines)
- Anesthesia-related complications
- Blood clots
- Early menopause if ovaries are removed
Recovery Tips
- Follow activity restrictions as advised by your doctor.
- Maintain a healthy diet to promote healing.
- Stay hydrated and take prescribed medications.
- Attend follow-up appointments for monitoring.
At our hospital in Nagpur, vaginal hysterectomy and LAVH are the best surgical options for various gynecological conditions. The choice between vaginal hysterectomy and LAVH depends on the patient’s specific situation, the complexity of the case, and the surgeon’s expertise. Both procedures at our hospital in Nagpur offer the benefits of minimally invasive surgery with relatively quick recovery times and reduced postoperative pain.
