Comparative clinical study of laparoscopic assisted vaginal hysterectomy and non-descent vaginal hysterectomy

Background: Laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly becoming popular. It's really a technique made to replace abdominal hysterectomy. The need of the hour is the minimal invasive surgery, early discharge from the hospital, early resumption of work, avoidance of disfiguring scar on the abdomen and cost-effectiveness of the procedure which are as important as cure of the disease. The objective of this study is to compare the effectiveness and safety of laparoscopic and vaginal hysterectomies for non-descent uteri (NDVH).Methods: The study was undertaken in the department of obstetrics and gynecology, Amrita Institute of Medical Sciences, Kochi for the period of one year. About 50 women in each group undergoing LAVH and NDVH for benign pelvic conditions were studied preoperatively, intra-operatively and post-operatively in detail for indications, operative time, intraoperative blood loss, duration of stay in hospital.Results: The mean operative time in LAVH was 240.6 minutes and in NDVH 168.3 minutes. Minimum duration of stay was in LAVH 3 days and in NDVH 4 days. Mean duration of stay in both groups was 6.4 days. Maximum duration of stay-15 days in both groups.Conclusions: LAVH is a better approach for a larger uterus whereas NDVH is preferable for a small uterus, not only for shorter operative time and minimal wound, but also for much lower costs

Ruptured cornual ectopic pregnancy at 8 weeks gestation- successful conservative approach: a case report

Cornual pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture with resultant life threatening hemorrhage. The mortality of interstitial pregnancies is more than twice that of other tubal pregnancies.  Cornual pregnancies often rupture later than other tubal pregnancies because the myometrium is more distensible than the fallopian tube. We report a case where a patient presented at 8 weeks of gestational age with ruptured cornual ectopic pregnancy and hemoperitoneum. Emergency Laparotomy was done and cornual rupture was sutured successfully. Close monitoring of pregnancies in these patients is important to prevent a deleterious delay in treatment of a cornual pregnanc