Hysterectomy Vaginal /Abdominal /LAVH & TLH

A hysterectomy is a surgical procedure to remove the uterus. There are different approaches to performing a hysterectomy, and the choice of approach depends on the patient's medical condition, the reason for the surgery, and the surgeon's expertise. The three common approaches to hysterectomy are vaginal hysterectomy, abdominal hysterectomy, and laparoscopically assisted vaginal hysterectomy (LAVH) or total laparoscopic hysterectomy (TLH):

Vaginal Hysterectomy: In a vaginal hysterectomy, the surgeon removes the uterus through the vaginal canal. This approach is minimally invasive, as it does not require external incisions on the abdomen. It is typically used for cases in which the uterus can be removed without the need for additional surgical access. Vaginal hysterectomy is associated with a shorter recovery time, reduced postoperative pain, and a lower risk of complications compared to abdominal hysterectomy.

Abdominal Hysterectomy:Abdominal hysterectomy involves making an incision in the abdominal wall, usually either a horizontal (bikini) incision or a vertical incision, to remove the uterus. It is used in cases where the uterus is large, if there are significant adhesions or scar tissue from previous surgeries, or if other pelvic organs need evaluation or treatment. Recovery time for abdominal hysterectomy is typically longer than for the vaginal approach, and it may result in more postoperative pain and a higher risk of complications.

Laparoscopically Assisted Vaginal Hysterectomy (LAVH):: LAVH is a hybrid approach that combines laparoscopic and vaginal techniques. It involves making small abdominal incisions (ports) through which a laparoscope and surgical instruments are inserted to assist in the removal of the uterus. It is used when there is a need for a more detailed examination of pelvic organs, such as the ovaries, fallopian tubes, or when the surgeon needs additional visualization and precision. LAVH offers some of the benefits of minimally invasive surgery, with smaller incisions and reduced postoperative pain compared to abdominal hysterectomy

Total Laparoscopic Hysterectomy (TLH)::TLH is a purely laparoscopic approach where the entire surgery is performed through small abdominal incisions, typically three to four ports. It is considered the least invasive approach and is associated with the shortest recovery time, less pain, and smaller scars. TLH is suitable for cases in which the uterus needs to be removed, but the surgeon can access and remove it laparoscopically.

The choice of the hysterectomy approach is influenced by factors like the patient's health, the reason for the surgery, and the surgeon's expertise. It's essential to discuss the options with a gynecologist or a surgeon specializing in minimally invasive gynecologic surgery to determine the most appropriate approach for each individual case.