Or are they likely to utilize abdominal hysterectomy
more than in the past?
The total QALYs in the group of 100,000 women undergoing morcellation was estimated at 499,171, compared with 490,711 over 5 years in the abdominal hysterectomy
(7) Though most of the studies conducted confirm the superiority of the vaginal hysterectomy over abdominal hysterectomy
, the incidence of abdominal hysterectomy
versus vaginal is still more (3: 1).
The mean operation time was 103.2 minutes in laparoscopic method, 93 minutes in NDVH (Non Descent Vaginal Hysterectomy) and 90.6 minutes in AH(Abdominal Hysterectomy
) (P<0.05) (Table no.
For the sake of this discussion, I will assume that the hysterectomy is being performed for a benign indication as I highlight the Mayo Clinic approach to total abdominal hysterectomy
Laparoscopic assisted vaginal hysterectomy (LAVH) is comparable to Total abdominal hysterectomy
in terms of patients' benefits such as less blood loss, less analgesia use, reduced intraoperative and post-operative complication rates, less postoperative pain, rapid patient recovery and shorter hospital stay (12).
is a better choice in those cases where the size of uterus was too big to deliver it vaginally or in presence of old surgery scars on abdomen where there were chances of adhesions in the peritoneal cavity or in those cases with a doubt of malignancy so that abdominal cavity could be visualized thoroughly.
CASE REPORT: A 55 years multiparous patient who had undergone abdominal hysterectomy
9 years back for abnormal uterine bleeding admitted in Bharati Vidyapeeth Medical College, Sangli.
An abdominal hysterectomy
and bilateral oophorectomy specimen was received at Histopathology Section, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi in April 2017.
Population: Sixty-two women scheduled for total abdominal hysterectomy
for a benign indication.
There are not many simulation I models available for teaching abdominal hysterectomy
, but here we discuss 2 that we utilize in our residency program.
"Our study suggests that uterine weight is not an appropriate indication for abdominal hysterectomy
--that we can, and should, offer a laparoscopic approach even for a markedly enlarged uterus," she said.