Garofalo Obgyn

A recent medical study found that women who had a laparoscopic hysterectomy generally experienced less blood loss, less pain and a shorter hospital stay compared with women who had a vaginal hysterectomy.

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Hysterectomy, or surgical removal of the uterus, can be performed in different ways, including open surgery, laparoscopically, and vaginally. Open surgery provides the most effective way to ensure complete removal of the reproductive system but requires a wide incision through the abdominal wall. Laparoscopic hysterectomy is a minimally invasive procedure that uses thin, fiber-optic telescopes passed through into the abdomen through small cuts in the abdominal wall. In a vaginal hysterectomy, the surgeon operates entirely through the vagina.

While many tests have compared the safety and effectiveness of open and laparoscopic hysterectomies in recent years, relatively few have compared vaginal and laparoscopic hysterectomies. Many tests comparing vaginal and laparoscopic hysterectomies have concluded that vaginal hysterectomies are superior to laparoscopic hysterectomies.

Between April 2004 and April 2006, a team of physicians in Milan, Italy conducted a study to compare the two types of procedures. Sixty women participated in the study, with 30 having a laparoscopic hysterectomy and the other 30 undergoing a vaginal hysterectomy. Women with various medical complications or conditions that might have interfered with the study’s results were excluded. The results were published in the April 2009 American Journal of Obstetrics & Gynecology.

The study found that while the laparoscopic procedure took more time on average, the women who had a laparoscopic hysterectomy generally experienced less blood loss and a shorter hospital stay compared with the women who had a vaginal hysterectomy.

Average Comparisons

Laparoscopic                                         Vaginal

Average blood loss                                83.9 ml                                                178.2 ml

Average hospital stay                           2.7 days                                                3.2 days

Average length of operation               99 minutes                                          82 minutes

Candiani. Laparoscopic vs vaginal hysterectomy for benign pathology. Am J Obstet Gynecol 2009.

Following the procedure, the women who had a laparoscopic hysterectomy generally reported a lower average level of pain on the day of the surgery and experienced faster recovery from pain in the days that followed. The average number of days before returning to work was not significantly different between the two groups.

The women came in for check-ups one, six and 12 months after their procedures. They were evaluated in terms of pelvic pain, urinary dysfunctions, sexual activity, vaginal infections and other factors. Based on clinical and ultrasound evaluations, the two procedures were equally effective.

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Candiani M, Izzo S, Bulfoni A, et al. Laparoscopic vs vaginal hysterectomy for benign pathology. Am J Obstet Gynecol 2009;200:368.e1-368.e7