Minilaparotomically Assisted Vaginal Hysterectomy

Endoscopic hysterectomy is increasingly selected as a current trend to minimize invasion, tissue trauma and early recovery. However it has disadvantages of the difficulty to learn and needs expensive equipments. So we developed a new minimally invasive method of vaginal hysterectomy-minilaparotomically assisted vaginal hysterectomy (MAVH) in order to complement the current laparoscopic surgery. The principle of MAVH is based on suprapubic minilaparotomical incision and uterine elevator that allows access and maximal exposure of the pelvic anatomy and an easy approach to the surrounding anatomy enabling division of round ligaments, Fallopian tubes, tuboovarian ligaments, and dissection of bladder peritoneum. After then, the vaginal phase of MAVH is done by the traditional vaginal hysterectomy. We enrolled 75 consecutive cases and in 73 cases thereof MAVH was accomplished successfully. The technique of MAVH is simple and easy to learn and it involves a small incision causing less pain and complications. This practice does not require expensive equipments. MAVH is considered as a safe and effective alternative method for abdominal hysterectomy in most cases.