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Laparascopic vs. vaginal hyst.? Laparascopic vs. vaginal hyst.?

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Unread 01-11-2006, 01:53 PM
Laparascopic vs. vaginal hyst.?

Sorry, I don't know how to spell laparascopic!
I was wondering if anyone could tell me why one would be scheduled for a laparoscopy, if a vaginal would do?
Personally, I am scheduled for a lap w/vaginal, and then I'll have an abdominal if they determine it once they see it. But a friend asked me why they were even bothering with a laparoscopy. Can't they go in vaginally, take out the uterus and everything, and then if it's determined the endo is too bad, or I need some reconstruction on the rectum and/or bladder (I might), they could progress to the laparoscopy or abdominal, whichever is best suited? Does ANY of that make sense??? LOL
Thanks ladies,
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Unread 01-11-2006, 02:25 PM
Laparascopic vs. vaginal hyst.?

Okay, if I understand correctly, you have endo and they suspect you may need repairs. These are probably your biggest clues as to why you are scheduled for a LAVH (lap asissted vaginal hyst) vs. the TVH (total vaginal hyst). With the LAVH, the dr is able to work within your abdominal area without having to use a long incision as with the TAH (total abdominal hyst).

Because I, too, have endo, I had the LAVH. I had had a lap a few weeks prior to my hyst so my dr had already cauterized most of the endo then. During your LAVH, your dr may cauterize what endo is found and can safely be cauterized.

There is a lot of information in our Resource Database, including LAVH Resources and Surgical Choices Defined. You can search for issues concerning your circumstances in the database. You may also wish to use the seacrch tab at the top of your screen, towards the right, where you can find other threads posted by other members.

Best wishes to you for your hyst and I hope you find information that is helpful to you here at the site.
Unread 01-11-2006, 02:30 PM
Laparascopic vs. vaginal hyst.?

Hi Casey,

It sounds like you are having a LAVH (Laparoscopic Vaginal Hysterectomy)?? It sounds like your Dr. may have advised you he might have to do a ~conversion~ after surgery starts and change over to an abdominal hyst. If that is so, you might ask him what his conversion rate is from lap to abdominal. It sounds like he wants to do a less invasive surgery and just needs a Plan B if anything is different then expected. Hope that answers your question. If not, stupid me, I did understand the question.

Best wishes,

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Unread 01-11-2006, 03:12 PM
Laparascopic vs. vaginal hyst.?

Hi Weiser, hi Mary. :-)
Thank you for the links. I'll check them out. Mary, you sound like my dr.! LOL THat's exactly what she said! It was only while talking to a friend this morning, that we started wondering WHY she (dr.) would want to put cuts in my belly (lap cuts; not ab cuts right now) when instead she could just take it all out vaginally (if conditions allowed). Is
it because she might be doing work on rectum and/or bladder? Can you not work on these areas vaginally? My friend thought that once the uterus and everything came out, they'd have a wide open view! lol
Unread 01-11-2006, 03:18 PM
Laparascopic vs. vaginal hyst.?

Hi Casey,

I am sure Weiser can answer your question about the bladder and rectum. Honestly, I do not know.

Unread 01-11-2006, 03:25 PM
I was wondering about that, too.

My Dr. is going to be performing a abdominal hysterectomy. He is only removing my uterus, and one ovary, keeping the other ovary. His reasoning for keeping one, is that I cannot take hormones, hopefully, keeping the one ovary, I won't have to. But, I was not sure why he had to do it abdominaly and not vaginaly. I know the recovery is longer for ab. isn't it? Does adenomyosis have alot to do with his decision?
Unread 01-11-2006, 03:30 PM
Laparascopic vs. vaginal hyst.?

To: Angelsnlma,

From what I understand of a laparoscopic hyst, it can come down to a Dr's medical training and the size of the uterus at the time of surgery. I actually did (3) months of lupron shots in pre-op to shrink my fibroids enough for a LSH.

Best wishes,

Unread 01-11-2006, 03:38 PM
Laparascopic vs. vaginal hyst.?

Thank you! My doc says my uterus is 3 times it's normal size. He is an awesome dr. and I trust him alot, so I guess that counts for something, huh"
Unread 01-11-2006, 04:00 PM
Laparascopic vs. vaginal hyst.?

With the LAVH, you will have three small cuts: one in your belly button (I can't see the scar for the other typical belly button lines) and one near each hip--you can barely see my not even a half inch scar on the left (it is a slight bump), and get our your magnifing glass for the very light, maybe quarter inch scar on the right hip. Instruments and camera are placed in the incisions and gas is used to swell the abdomen. Thus, much work can be done in the abdomenal and plevic region, without having to cut you wide open--to be blunt. With the TVH, they are still working through the opening of your vagina, so there is not as much room to maneuver. And, any hyst can be changed to abdonminal IF the openings of the less envasive hyst become too small due to complications, larger uterus or fibroids than expected, etc.

If the dr is skilled enough, some repairs to other organs can be completed with the LAVH, due to the work space created by swelling the abdomen with gas and the use of instruments and camera through the small incisions.

We are all unique and we all require unique procedures. And our drs are also all unique--they have different training backgrounds, have seen different results with various procedures, encountered various complications that have affected the way they practice medicine, etc. Therefore, it is always best to ask your specific dr your specific questions, to see how and why it applies to you. Feel free to write down questions, take copies of information you have found, bring up issues that the dr has not addressed.

I trusted my GP who referred me to my GYN. And I asked a lot of questions--but I still did not ask all of them I could. I am willing to ask him why this or why that, or why does this not apply to me, why does this apply to me. And I go back to my GP and tell her what the GYN said and ask if she agrees.

You need to be comfortable with the surgery of choice and your surgeon. If you are not, ask questions and research until you are, even if that may mean a postponement of your hyst. A hyst is irreversible and thus you need to go into the surgery with your eyes wide open, knowing you have made the right decision for you and your circumstances.

Does this info help? Please keep talking to your dr and asking questions until you are comfortable in your own mind.
Unread 01-11-2006, 04:16 PM
Laparascopic vs. vaginal hyst.?


Also make sure that your doctor is not giving you the option of an LSH, a laparoscopic supracervical hysterectomy. This procedure is done totally through small cuts in the abdomen, and no entry through the vagina at all. The main advantage would be that you would have a possiblility of keeping your cervix if it is healthy and you don't have the virus HPV, whereas in a vaginal the cervix is removed.


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