Overview | MIVH | LAVH | TVH | TAH | Radical Hysterectomy | LH | LSH | HALS
Dr. Turrentine used to perform LAVH and helped the insurance industry establish codes for this once modern procedure. Over the years, however, Dr. Turrentine realized that the patients continued to have discomfort from the gas that had to be placed into the abdomen. Even though the patients had smaller incisions than the traditional hysterectomy, there were still usually three, four, or more. These incisions had to be placed through seven layers of tissue. The patients did not "bounce" back as quickly as he thought they should from an LAVH.
Just as tonsils are removed through a natural orifice without "holes" or incisions being placed in the neck, MIVH is performed through the natural orifice of the vagina. Dr. Turrentine developed and now teaches MIVH throughout the country. MIVH is now becoming the hysterectomy of choice as it allows faster recovery, less pain, and faster return to normal activities for the patient. For the surgeon, it is faster and less expensive.
Unlike the traditional vaginal hysterectomy, MIVH follows several protocols including pre-operative preparation to reduce infection and nausea. There are only two small incisions made in the back of the vagina where there are a minimal number of nerves. These incisions go through only two layers of tissue. A new instrument that staples and cuts during one firing is placed through the two incisions and used to slide off the uterus. The uterus is removed easily and quickly therefore less time is required and less anesthesia (that makes some people sick) is needed. A special "JET" pack is placed into the pelvis and tagged to the outside so there is never any chance of any sponges and/or lap packs left behind. This special pack allows the pelvis to be directly visualized so endometriosis and other conditions can be treated directly without looking through camera lens. Dental mirrors are occasionally used to see around "tight" corners. This pack also allows easy removal of the ovaries, tubes, or appendix through the vagina if these procedures also need to be done. No catheters or vaginal packs are needed unless bladder procedures are done at the same time.