Evaluation of the Development of Laparoscopically-Assisted Vaginal Hysterectomy in the Czech Republic over the Last 10 Years Based on the Data of the National Registry of Gynecology Laparoscopy Complications

Overview

Objective:
To survey the performance of laparoscopically assisted vaginal hysterectomy (LAVH) and other gynecologic laparoscopic operations performed in the Czech Republic. This series covers a period of 10 years, in which 23889 LAVH was performed.

Design:
Retrospective study (Canadian Task Force classification II-3).

Methods:
Two questionnaires were sent each year to more then one hundred of clinics performing laparoscopic gynecologic operations.

Results:
In 2005, 52% of clinics responded with a total of 4062 LAVH operations. The most frequently reported indication for LAVH in 2005 were uterus myomatosus (58%), uterine bleeding (18%) and adnexectomy (9%). The overall complication rate in 2005 during LAVH was 6,9% (n=280), the rate of complications requiring laparotomy was 3,9% (n = 161). Increased experience with LAVH over last 10 years has had two consequences: a significant drop in the number of complications (14,7% in 1996 and 6,9% in 2005) and a drop in the mean time of duration of an operation (101 minutes in 1996 and 82 minutes in 2005).

Conclusion:
LAVH is replacing abdominal hysterectomy, which means significantly less discomfort and shorter hospital stay for patients.

Key words:
National Registry of Complications, laparoscopically-assisted vaginal hysterectomy (LAVH), laparoscopic hysterectomy (LH), total laparoscopic hysterectomy (TLH), laparoscopic supravaginal hysterectomy (LSH), laparoscopically-assisted radical hysterectomy (LAVRH)