In LAVH, several small incisions (cuts) are made in the abdominal wall through which slender metal tubes known as "trocars" are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope is essentially a tiny telescope. A camera attached to it provides a continuous image that is magnified and projected onto a television screen which the surgeon during the operation.
In the course of LAVH, the uterus is detached from the ligaments that attach it to other pelvic structures using the laparoscopic tools. If the tubes and ovaries are to be removed, they are also detached from their ligaments and blood supply. Then whatever is to removed is taken out through an incision made in the vagina.
Since the incisions are small, the scarring, pain and recovery time from LAVH are usually less than with an abdominal hysterectomy which requires both a vaginal incision and a 4-6 inch (10-15 cm) long incision in the abdomen.
Not all hysterectomies can be done by LAVH. There are certain conditions that necessitate abdominal or vaginal hysterectomy.