Laparoscopic assisted vaginal hysterectomy of the large uterus using ultrasonic dissection.

Laparoscopic assisted vaginal hysterectomy (LAVH) is a procedure gaining in popularity over abdominal hysterectomy, for a number of different indications. According to a recent study by Wilcox, et al., over 1.7 million women underwent a hysterectomy procedure in the U.S. from 1988 through 1990, and two-thirds of the procedures for benign disease were performed for leiomyomata or endometriosis, indications typically afflicting women of child-bearing age. Seventy-five percent of the procedures included in the Wilcox study were abdominal hysterectomies, the remainder being vaginal hysterectomies. National Hospital Discharge Summary data reveal that 562,000 hysterectomies were performed in 1993, rendering hysterectomy second only to cesarean section in volume of annual Ob/Gyn surgical procedures performed.