ADVANTAGES OF VAGINAL HYSTERECTOMY OVER TRADITIONAL ABDOMINAL HYSTERECTOMY
No abdominal wound:
There is no cutting of the abdomen to reach the uterus. This surgery is purely done through the vagina and hence there is no abdominal wound and hence no associated wound complications like delayed healing, wound discharge, etc which is a known complication in high risk cases like in diabetics, elderly, obese and over weight patients and in some patients maintaining a poor hygiene post surgery.
Most patients have post operative pain due to the cutting of the abdomen and the skin incision which is very sensitive to pain. As you now already know that there is no cutting of the abdomen and hence lesser pain and less need for powerful painkillers and their associated side effects.
Early recovery and mobility:
The patient is comfortable and fully mobile in about 24 to 48 hours post surgery, making this an ideal procedure for working women and busy house wives. Most patients can resume full activity in five to seven days time.
Lesser blood loss:
Upto 20 to 30 % lesser blood loss compare to traditional abdominal hysterectomy and hence our choice for anaemic patients.
Surgery of choice in high risk patients:
Patients very often have high risk factors like diabetes, hypertension, anaemia, heart disease, lung disease, obesity and over weight and many others. These patients do not tolerate prolonged anaesthesia, blood loss or prolonged bed rest well. All these factors are eliminated through vaginal hysterectomy making this surgeon’s choice of an ideal surgery.
Advances in Gynecological Surgery
“NO SCAR HYSTERECTOMY”
AN INTRODUCTION TO HYSTERECTOMY
(Uterus removal surgery)
Hysterectomy (uterus removal surgery) is the second most frequently performed major surgical procedure on women all over the world. In United States, approximately 6,00,000 hysterectomies are performed each year due to various indications. In India, no national statistics for hysterectomy is available; however, hysterectomy is commonly done for many major gynaecological illnesses and is a highly effective cure.
Hysterectomy is usually done in women who are in the later part of the reproductive age group or in the senior ladies. Most of these patients who require uterus removal have some form of a major illness which has not responded adequately to medical management (non- surgical treatment). Some of these major diseases may include uterine fibroids, adenomyosis, uterine hyperplasia, excessive menstrual bleeding causing anaemia, uterine prolapsed (uterus coming out), cancers, etc.
AN INTRODUCTION TO NDVH- Non Descended Vaginal Hysterectomy
(No scar hysterectomy)
Hysterectomy (uterus removal surgery) is the commonest procedure performed in gynecology in the world. Traditionally various routes of removal of uterus have been used like abdominal approach, vaginal approach, laparoscopic (key hole) approach and various combinations of the above routes. Abdominal hysterectomy is undoubtedly the most popular with a 70:30 ratio for abdominal versus vaginal routes. Laparoscopic assisted vaginal hysterectomy (LAVH) enjoyed its place in the past decade when it became fashionable to perform a vaginal hysterectomy with the help of the laparoscope used abdominally. However, gynaecologists were soon to learn that hysterectomy could be performed easier, faster, with lesser complications, and with excellent patient recovery when the vaginal route only was used. This concept gave birth to the concept of Non Descended Vaginal Hysterectomy (NDVH).
This procedure is in practice since several decades, but has recently attained popularity due to its advantages. In fact, the latest randomised controlled studies to evaluate the role of abdominal v/s vaginal v/s laparoscopic hysterectomy in routine gynaecological practice concluded that major haemorrhage (excessive bleeding), hematoma (blood collection), ureteric injury (The ureter is the tube that carries urine from the kidney to the urinary bladder), urinary bladder injury and anaesthetic complications were more in the laparoscopic hysterectomy, compared to the abdominal and vaginal hysterectomies. In addition, an average laparoscopic hysterectomy takes twice to thrice as long as an average vaginal hysterectomy.
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ADVANTAGES OF VAGINAL HYSTERECTOMY (SCAR LESS) OVER LAPAROSCOPIC (KEY HOLE) HYSTERECTOMY:
Truely scarless v/s key hole:
Vaginal hysterectomy and laparoscopic hysterectomy are both surgeries that avoid the cutting open of the abdomen to reach the diseased uterus. But in vaginal hysterectomy, the abdomen does not have even one scar whereas in laparoscopic hysterectomy, there are at least four to five holes on the abdomen. These holes do lead to some scar (mark) on healing even in the hands of the best of the surgeons.
Lesser operative time:
Various Indian and international studies have shown that laparoscopic hysterectomies take two to three times more operating time than vaginal hysterectomies. This is ideal for patients who do not tolerate long anaesthesia and its associated risks.
Lesser chances of complications and organ injuries:
Studies show a lesser risk of injury to major organs (like ureters, bladder, intestines and major blood vessels) in vaginal hysterectomy as compared to laparoscopic hysterectomy.
Lesser anaesthesia related risks:
Vaginal hysterectomy is almost always done under spinal block which acts locally and has lesser side effects. Laparoscopic hysterectomy is done under general anaesthesia which has relatively more risks.
Also, due to the shorter operative time of vaginal hysterectomy, the risks associated with anaesthesia are further decreased.
Lesser treatment cost:
The laparoscopic machine is very costly and so also are the laparoscopic consumables. Vaginal hysterectomy is done using standard general surgical instruments and consumables. Because of the above reasons, vaginal hysterectomy is cheaper to the patient by 25 to 30 %. This cost difference makes vaginal hysterectomy and its benefits affordable to most people.
This modern surgery is now available in Vasco with all the associated benefits like no scar, less pain, early to home time and early to work times.