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Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

Surgeons at Baptist Health Paducah perform Laparoscopically Assisted Vaginal Hysterectomies, a new approach to hysterectomies for treating pelvic pain and bleeding disorders.

About the Procedure

Laparoscopically Assisted Vaginal Hysterectomy (LAVH) may be recommended by your gynecologist to relieve symptoms caused by abnormal growths in your uterus or pelvic cavity, such as:

  • Endometriosis, a condition in which the endometrium or uterine lining grows outside the uterus and forms scar tissue throughout the pelvic cavity;
  • Adenomyosis, abnormal growth of the endometrium into the muscle wall of the uterus; and
  • Fibroids, knots of muscle tissue growing out from or into the wall of the uterus.

Before the procedure, you will be given general anesthesia. You will also be catheterized so your bladder can empty during surgery. After you are asleep, your doctor will inflate your abdomen with carbon dioxide gas so he or she can get a clear view of your reproductive organs. Next, the laparoscope, which is about as thick as a pencil, will be inserted through a small incision in your abdomen. The laparoscope enables your doctor to see your reproductive organs on a video monitor. Other tiny incisions will be made for inserting surgical instruments.

Using these instruments, your doctor will cut the ligaments that connect your uterus to your pelvic wall. If you are having a salpingo-oophorectomy in addition to a hysterectomy, your ovaries and Fallopian tubes will also be detached. Once your uterus is detached from the pelvic wall, it is separated from the vagina by an incision. Then it is removed through the vagina. At the end of the procedure, the gas will be released and your incision(s) will be closed.

Recovering from LAVH

LAVH takes about two to three hours to perform. When the surgery is completed, you will be taken to Baptist Health Paducah's Post Anesthesia Care Unit where nurses will carefully monitor your progress for several hours until you are stable. Then you will be taken to an inpatient room where you will spend two or three days before going home.

Immediately after the surgery, you may feel drowsy or nauseated from the anesthesia. Another common side effect of any laparoscopic surgery is shoulder pain, caused by nerve irritation from the gas used to inflate your abdomen. You will receive pain medication as needed.

For the first day or two, your incisions may leak a small amount of pinkish fluid. You may also have vaginal spotting or a brownish discharge for several weeks afterward and may need to wear a pad until it subsides.

Recovering from any surgery takes time. You should be realistic in your expectations on how long it will take before you feel completely well. Most women feel fine within one to three weeks and many can return to work between three and ten days after the surgery. Your doctor will give you instructions on how to care for yourself after you go home and will advise you on exercise and activity levels.

Call your physician if you experience:

  • Chills or a fever of 100° F or higher
  • Bright red vaginal bleeding or a smelly discharge
  • Difficulty urinating or burning and frequency when urinating
  • Drainage from your incision sites
  • Pain, redness or swelling in one leg
  • Significant abdominal pain or bloating