Hysterectomy or removal of uterus is one of the commonly performed operations in Gynaecology. It is most commonly done by abdominal route. Previously vaginal route was reserved mainly for prolapsed uterus but now the outlook has changed and slowly the need for converting the abdominal route to the vaginal one in a nondescended uterus is being appreciated.

ADVANTAGES:

• Scar less surgery
• Needs lesser operating time than laparoscopic surgery
• Less cost when compared to laparoscopic surgery
• Can be done under regional anaesthesia thus further reducing cost and anaesthetic complications
• Early discharge from hospital
• Quick recovery and early return to activity
• Less postoperative pain
• Can be done in big uterus with tumour (14-16weeks size)
• Ovaries (if required) can be removed along with the uterus in NDVH

NDVH is already popularised in India for last fifteen years where majority of the hysterectomies are done through the vaginal route. For the past ten years several studies have been conducted and published comparing NDVH with abdominal hysterectomy and NDVH with laparoscopic hysterectomy confirming the superiority of the former in majority of the cases.

Surgery is an ever advancing subject and the surgical techniques have changed and evolved over ages to put forward the natural route as a new appraisal in Hysterectomy