Combined Laparoscopic Cholecystectomy (LC) and Laparoscopic Assisted Vaginal Hysterectomy (LAVH) is Feasible and Safe in Selected Cases

Aims: Laparoscopy has been practised for many years by both surgeons and gynaecologists and has made significant advances in last three decades. Laparoscopic Cholecystectomy (LC) has been the mainstay of treatment for gallstones for a long time. In recent years laparoscopy has been used more widely in gynaecology, where Laparoscopy Assisted Vaginal Hysterectomy (LAVH) has been performed with good results. The objective of this study was to evaluate the feasibility and outcome of performing both LC and LAVH in the same sitting.
Methods: Between May 2006 and May 2012, 42 women underwent LC and LAVH in the same sitting. Patients were jointly seen by surgeon and gynaecologist and selected following certain strict criteria. We retrospectively recorded postoperative complications, duration of operation and hospital stay. They were followed up in outpatient clinic at four and twelve weeks after discharge.
Results: Forty two women underwent both LC and LAVH in the same sitting. Mean duration of surgery was 160 minutes (range 140 - 245).Mean duration of hospitalisation was 64 hours (range 48 – 124 hrs). The pain experienced in the postoperative period measured on the visual analogue scale ranged from 2 to 7 with a mean of 3.8. Two (4.7%) patients had umbilical port site infection.
Conclusion: Both LC and LAVH can be performed together safely with minimum pain and morbidity. Appropriate selection of patients, preoperative planning and good communication between the surgical and gynaecological team is the key for success.