What is the difference between a laparoscopic-assisted vaginal hysterectomy and a total laparoscopic hysterectomy?
Both of these procedures are viable options for performing a hysterectomy, however, depending on the surgeon expertise, instrumentation available, or exposure at the time of surgery a surgeon may elect to perform one or the other. During a laparoscopic-assisted vaginal hysterectomy, the surgeon will start the procedure by laparoscopy and complete it by the vaginal approach. This generally entails initial evaluation of the abdominal and pelvic cavity by laparoscopy followed by transection (cutting) of the major blood vessels (infundibulopelvic vessels/ligament) that provide blood supply to the ovaries and uterus. The surgeon will then perform the remainder of the procedure vaginally. The total laparoscopic hysterectomy is performed in the setting where the surgeon is able to carry out all the steps of the procedure laparoscopically. This includes transection of all the blood supply to the uterus and separation of the uterus from the upper vaginal canal. The specimen is always removed th
