# LAVH vs Total laparscopic hysterectomy



## swyman (Feb 14, 2011)

Can someone tell me what the difference is between LAVH and a total laparscopic hysterectomy. Thank you.


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## preserene (Feb 14, 2011)

*LAVH*- Laparoscopy” assisted “Vaginal Hysterectomy-  laparoscopy  is used as an aid to Hysterectomy. In LAVH, laparoscopic inspection at the end of the procedure permits the surgeon to control any bleeding and evacuate clots. Laparoscopic cuff suspension may limit future vault prolapse. 
BUT, we should know there are many varieties of lapraroscopy   “USED” vaginal hysterectomy.
In Laparoscopy used vaginal Hysterctomy itself, there are variety .of surgeries- like: : 
a)	Diagn. Laparoscopy with vaginal hyst -  Lap used for diagnostic purposes to determine if  Vag. Hysterectomy is possible and also to ensure vaginal cuff and pedicle hemostasis and allows clot removal .
b)	 *Lapro. assisted vaginal Hysterectomy [LAVH] *– A VAGINAL HYSTERECTOMY AFTER LAPAROSCOPIC  adhesiolysis,endometriosis excision or oopherectomy.
c)	*Laparoscopic Hysterctomy[LH*] -  Laparo. Ligation of uterine artery either by electro surgery, suture ligature  or staples. All surgical steps after the uterine vessels desiccation, can be performed either VAGINALLY or laparascopically. LAPAROSCOPIC LIGATION OF THE UTERINE VESSELS IS THE SINE QUANON FOR LAPAROSCOPIC Hysterectomy.  Identification of the URETER is always advised.
d)	*Total Laparoscopic Hysterectomy [TLH]* – here the laparoscopic dissection CONTINUES until the uterus lies free of all attachment in the peritoneal cavity. The uterus is removed through the vagina with morcellation if necessary… The vagina is closed with sutures applied  laparoscopically . NO VAGINAL SURGERY IS DONE UNLESS MORCELLAITON  IS NECESSARY. Laparoscopic hysterectomy includes all cases using the laparoscope.

{  *LAVH* is* REALLY* a vaginal Hysterectomy  [almost all LAVH CAN BE DONE AS COMPLETE VAGINAL HYSTERECTOMY].  
 Total lapro. Hysterectomy [TLH]  implies that a Vaginal Hysterectomy will be difficult or impossible to perform ( ie)TLH  IS A SUBSTITUTE FOR ABDOMINAL HYSTERECTOMY but not for vaginal hysterectomy.}

e)	*Lapro. Supracervical Hysterectomy[LSH]* -  is a less risky procedure with decreased risk of ureter dissection. The uterus is removed by morcellation from above or below.

f)	*LAPAROSCOPIC. Pelvic Reconstruction [LPR] WITH VAGINAL HYSTERECTOM*Y.

I hope this could help you to differentiate between them and to assign  codes accordingly.


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