This video titled "Laparoscopic-Assisted Vaginal Hysterectomy (LAVH): A Minimally Invasive Approach to Uterine Removal" offers an in-depth look at one of the most refined surgical techniques for managing benign gynecological conditions requiring hysterectomy. LAVH skillfully merges the advantages of laparoscopy and vaginal surgery, offering patients a safer, less painful, and cosmetically superior alternative to traditional abdominal hysterectomy.

What is LAVH?

LAVH involves using laparoscopic techniques to mobilize the uterus, secure and ligate the uterine arteries, and manage adnexal structures, followed by vaginal removal of the uterus. The laparoscopic phase provides enhanced visualization of pelvic anatomy, allowing the surgeon to handle complex cases such as those involving fibroids, previous pelvic surgery, endometriosis, or uterine enlargement. The procedure ends with vaginal morcellation or delivery of the uterus and closure of the vaginal vault.

Key Surgical Steps Demonstrated in the Video

Creation of pneumoperitoneum and laparoscopic access
Identification and dissection of uterine ligaments and adnexal structures
Use of energy devices like harmonic scalpel or ligasure for precise hemostasis
Mobilization of the uterus with minimal trauma
Vaginal removal of the uterus and suturing of the vault

Clinical Advantages of LAVH

Smaller abdominal incisions and better cosmetic outcomes
Less postoperative pain and faster ambulation
Reduced intraoperative blood loss due to precision control of vessels
Shorter hospital stay and quicker return to daily activities
Better option in patients with restricted vaginal access or pelvic adhesions

Who Can Benefit from LAVH?

LAVH is ideal for patients with:

Symptomatic fibroids or adenomyosis
Abnormal uterine bleeding unresponsive to medical therapy
Stage I endometrial cancer (in select cases)
Endometriosis or pelvic adhesions
Uteri not suitable for purely vaginal hysterectomy

Conclusion

Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) is a versatile and patient-friendly surgical approach that bridges the benefits of laparoscopy with the advantages of vaginal surgery. This video provides a comprehensive visual guide to the procedure, from port placement to uterine delivery, along with expert commentary on surgical tips, energy sources, and safety measures.

Watch the full video to learn how LAVH is performed, understand its clinical indications, and explore how this hybrid technique is transforming gynecological care.
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