What is laparoscopically assisted vaginal hysterectomy?

Laparoscopically assisted vaginal hysterectomy (LAVH) removes the uterus through the vagina. The cervix is usually removed too. In some cases, the ovaries and fallopian tubes are taken out at the same time.

The doctor makes one or more small cuts in the belly. These cuts are called incisions. They let the doctor insert tools to do the surgery. One of these tools is a tube with a light on it. It's called a laparoscope, or scope. The scope and the other tools allow the doctor to free the uterus. Then the doctor makes a small cut in the vagina. The uterus is taken out through this cut.

You may go home the day of surgery or stay in the hospital 1 to 2 days after surgery. And you may need about 4 to 6 weeks to fully recover. The recovery time may be shorter for some people.

After the surgery, you will not have periods or be able to get pregnant. Most people can have sex without problems after they recover.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• Avoid strenuous activities, such as biking, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• You may shower. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when you can drive again.
• You will probably need to take about 2 weeks off from work. It depends on the type of work you do and how you feel.
• Ask your doctor when it is okay for you to have sex.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• You may have stitches over the cuts (incisions) the doctor made in your belly. If you have strips of tape on the incisions the doctor made, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Other instructions

• You may have some light vaginal bleeding. Wear sanitary pads if needed. Do not douche or use tampons.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Laparoscopically assisted vaginal hysterectomy (LAVH) removes the uterus through the vagina. Your doctor used a lighted tube and surgical tools inserted through small cuts (incisions) in the belly. Then the doctor made a small cut in the vagina. Your uterus was taken out through this cut.

You can expect to feel better and stronger each day. But you might need pain medicine for a week or two. After a laparoscopy, you may have shoulder pain. This is caused by the air your doctor put in your belly to help see your organs better. The pain may last for a day or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery. And you also may have light vaginal bleeding for a few weeks.

It's important to avoid lifting while you are recovering so that you can heal. It may take about 4 to 6 weeks to fully recover. The recovery time may be shorter for some people.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, please take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 2 to 4 hours.