LAVH, laparoscopic supravaginal amputation of the uterus, laparoscopic hysterectomy
Among the many currently existing operations to remove the uterus less traumatic, safe and cosmetically operations are carried out by laparoscopy. The main operations are performed in the clinic include: LAVG, laparoscopic supravaginal amputation of the uterus, laparoscopic hysterectomy.
Laparoscopicaly assisted vaginal hysterectomy (LAVG, vaginal hysterectomy with laparoscopic-assisted, LAVH, Laparoscopically Assisted Vaginal) - one of the operational methods of removal of the uterus. LAVG is a safe alternative to abdominal (laparotomic) hysterectomy in case of inability to perform vaginal hysterectomies. Advantages of laparoscopic assistiruemoy vaginal hysterectomy: a minimally invasive, traumatic and blood loss, excellent visualization, early rehabilitation, cosmetic effect.
The surgical procedure.
After performing laparoscopic upper uterine ligaments coagulation, if necessary, dissect adhesions, endometriosis excised. All further stages of the operation, including the crossing of the uterine artery, performed vaginal access. Removal of the uterus is removed through the vagina. Vaginal stump sutured.
Subtotal laparoscopic hysterectomy (amputation of uterus supravaginal) shows the young patients in the absence of cervical pathology.
After performing laparoscopic upper uterine ligaments intersect, if necessary, dissect adhesions, endometriosis excised. Exposed uterine vessels are burnt. The uterus is cut off at the level of the internal os (leaving the cervix). Remote retrieved the body of the uterus from the abdominal cavity after supravaginal hysterectomy using electromechanical morcellator by "crushing" and removed from the belly piece by piece.
Total laparoscopic hysterectomy (hysterectomy) is shown in those cases where, for one reason or another can not perform vaginal hysterectomy.
Indications for laparoscopic access selection:
• anatomical featuresw (narrow pubic arch, narrow vagina, marked arthritis, prevents the location of the patient in position for lithotomy);
• severe obesity;
• the need for surgery on uterine appendages or their disposal;
• the need for revision of the abdominal cavity, subphrenic space, lymph nodes;
• laparotomic previously deferred transaction with an expected significant adhesive process;
• size of the uterus for more than 12 weeks of pregnancy (nulliparous women).
After performing laparoscopic upper uterine ligaments intersect, if necessary, dissect adhesions, endometriosis excised. Exposed uterine vessels, Burn, crossed vascular bundles on both sides. The uterus is cut off from the abdomen on a level vaults, removed through the vagina, vagina is restored several interrupted sutures.
After laparoscopic surgery shows early activation. Patients are allowed to get up at the 1st day after the operation, but then allowed to receive liquid food. Antibiotic treatment is assigned based on the indications for surgery, as well as the duration and suffering trauma intervention. Due to the high risk of thromboembolic complications after laparoscopic hysterectomy is prescribed anticoagulants, most low molecular weight heparin (LMWH).
Patient treatment lasts from 2 to 5 days. Employability is restored 4-6 weeks.
After the surgery is recommended to abstain from sexual activity for 4-6 weeks.