Laparoscopic-Assisted Vaginal Hysterectomy vs Laparoscopic Supracervical Hysterectomy for Treatment of Nonprolapsed Uterus


      Study Objective

      To compare perioperative outcomes between laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) for the nonprolapsed uterus.


      Retrospective chart analysis (Canadian Task Force classification II-2).


      Three university-affiliated community hospitals.


      Women undergoing LAVH or LSH because of benign indications without concomitant pelvic organ prolapse.


      Laparoscopic hysterectomy with or without adnexectomy.

      Measurements and Main Results

      Data from 265 LAVH procedures and 181 LSH procedures performed at 3 university-affiliated community hospitals were included in the analysis from January 2001 to December 2007. The cases were successive. Exclusion criteria included surgery performed to treat malignancy or pelvic organ prolapse, and procedures that were converted to laparotomy. Two hundred forty-eight LAVH procedures and 173 LSH procedures were completed successfully. There was no significant difference in mean (SD) operating time between the 2 groups (145.1 [45.6] minutes for LAVH vs 143 [51.7] minutes for LSH; p = .66). Hospital stay was significantly shorter in the LSH group (1.6 [0.6] days vs 1.2 [0.5] days; p = .001). Patients in the LAVH group had significantly larger uterine weight (147.7 [84.8] g vs 121.5 [105.5] g; p = .005). Postoperative hemoglobin change and febrile morbidity were similar between the groups, as were overall perioperative complications (19% vs 15%, respectively; p = .36) and conversion rate to laparotomy (6.9% vs 4.6%; p = .27).


      Compared with LAVH, LSH offers the benefits of a shorter hospital stay when performed in patients without uterine prolapse. Other perioperative outcomes studied were not significantly different between groups.


      To read this article in full you will need to make a payment
      AAGL Member Login
      AAGL Member, full access to the journal is a member benefit. Use your society credentials to access all journal content and features.
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Whiteman M.K.
        • Hillis S.D.
        • Jamieson D.J.
        • et al.
        Inpatient hysterectomy surveillance in the United States, 2000–2004.
        Am J Obstet Gynecol. 2008; 198: 34.e1-34.e7
        • Nieboer T.E.
        • Johnson N.
        • Lethaby A.
        • et al.
        Surgical approach to hysterectomy for benign gynaecological disease.
        Cochrane Database Syst Rev. 2009; : CD003677
        • Nezhat C.
        • Nezhat F.
        • Admon D.
        • et al.
        Proposed classification of hysterectomies involving hysterectomy.
        J Am Assoc Gynecol Laparoscop. 1995; 2: 427-429
        • Richardson R.E.
        • Bournas N.
        • Magos A.L.
        Is laparoscopic hysterectomy a waste of time?.
        Lancet. 1995; 345: 36-41
        • Jenkins T.R.
        Laparoscopic supracervical hysterectomy.
        Am J Obstet Gynecol. 2004; 191: 1875-1884
        • Parker W.H.
        Total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy.
        Obstet Gynecol Clin North Am. 2004; 31: 523-537
        • Reich H.
        Laparoscopic hysterectomy.
        Surg Laparosc Endosc. 1992; 2: 85-88
        • Semm K.
        Hysterectomy via laparotomy or pelviscopy: a new CASH method without colpotomy.
        Geburtshilfe Frauenheilkd. 1991; 51 ([in German]): 996-1003
        • Ghomi A.
        • Hantes J.
        • Lotze E.C.
        Incidence of cyclical bleeding after laparoscopic supracervical hysterectomy.
        J Minim Invasive Gynecol. 2005; 12: 201-205
        • Okaro E.O.
        • Jones K.D.
        • Sutton C.
        Long term outcome following laparoscopic supracervical hysterectomy.
        BJOG. 2001; 108: 1017-1020
        • Thakar R.
        • Ayers S.
        • Clarkson P.
        • et al.
        Outcomes after total versus subtotal abdominal hysterectomy.
        N Engl J Med. 2002; 347: 1318-1325
        • Gimbel H.
        • Zobbe V.
        • Andersen B.M.
        • et al.
        Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results.
        BJOG. 2003; 110: 1088-1098
        • Learman L.A.
        • Summitt Jr., R.L.
        • Varner R.E.
        • et al.
        A randomized comparison of total or supracervical hysterectomy: surgical complications and clinical outcomes.
        Obstet Gynecol. 2003; 102: 453-462
        • Lyons T.L.
        Laparoscopic supracervical hysterectomy: a comparison of morbidity and mortality results with laparoscopically assisted vaginal hysterectomy.
        J Reprod Med. 1993; 38: 763-767
        • Richards S.R.
        • Simpkins S.
        Laparoscopic supracervical hysterectomy versus laparoscopic-assisted vaginal hysterectomy.
        J Am Assoc Gynecol Laparosc. 1995; 2: 431-435
        • Lalonde C.J.
        • Daniell J.F.
        Early outcomes of laparoscopic-assisted vaginal hysterectomy versus laparoscopic supracervical hysterectomy.
        J Am Assoc Gynecol Laparosc. 1996; 3: 251-256
        • Schwartz R.O.
        Laparoscopic hysterectomy: supracervical vs. assisted vaginal.
        J Reprod Med. 1994; 39: 625-630
        • Kim D.H.
        • Bae D.H.
        • Hur M.
        • et al.
        Comparison of classic intrafascial supracervical hysterectomy with total laparoscopic and laparoscopic-assisted vaginal hysterectomy.
        J Am Assoc Gynecol Laparosc. 1998; 5: 253-260
        • Washington J.L.
        Laparoscopic supracervical hysterectomy compared with abdominal, vaginal, and laparoscopic vaginal hysterectomy in a primary care hospital setting.
        JSLS. 2005; 9: 292-297
        • Abdelmonem A.
        • Wilson H.
        • Pasic R.
        Observational comparison of abdominal, vaginal and laparoscopic hysterectomy as performed at a university teaching hospital.
        J Reprod Med. 2006; 51: 945-954
        • Milad M.P.
        • Morrison K.
        • Sokol A.
        • et al.
        A comparison of laparoscopic supracervical hysterectomy vs laparoscopically assisted vaginal hysterectomy.
        Surg Endosc. 2001; 15: 286-288
        • El-Mowafi D.
        • Madkour W.
        • Lall C.
        • et al.
        Laparoscopic supracervical hysterectomy versus laparoscopic-assisted vaginal hysterectomy.
        J Am Assoc Gynecol Laparosc. 2004; 11: 175-180