Laparoscopic Hysterectomy

When Is Laparoscopic Hysterectomy Done?

The procedure is carried out when conservative medication has failed to address the symptoms and resolve the underlying uterine issues. Common patient conditions include:

• Severe pelvic pain
• Fibroids which are symptomatic
• Heavy abnormal uterine bleeding
• Early-stage uterine, cervical, and ovarian cancers (when appropriate)
• Endometriosis and adenomyosis

Types Of Laparoscopic Hysterectomy

Below are various types of laparoscopic hysterectomy, categorised based on the portion of the uterus removed and the surgical approach followed.

• Total Laparoscopic Hysterectomy (TLH): Removal of the uterus and cervix as a whole. This technique is completely laparoscopic. The removal of uterus is from vagina if uterus is small and if large it is morcellated that is made into small pieces with the help of special instrument called morcellator.
• Laparoscopic supracervical hysterectomy (LSH): This is sometimes called a partial or subtotal hysterectomy. This is the removal of the upper part of the uterus with the cervix left in place. Then the detached uterus is removed in pieces through tiny cuts in the stomach.
• Laparoscopically assisted vaginal hysterectomy (LAVH): A hybrid procedure in which the surgeon uses tools from the laparoscope to detach only the upper part of the uterus. The remainder of the uterus and cervix are then removed through an incision at the top of the vagina.
• Associated organ removal: Your surgeon may also perform the removal of fallopian tubes and ovaries depending on the medical necessity, or to prevent future cancer.

Who Is A Candidate For Laparoscopic Hysterectomy?

Laparoscopic hysterectomy is suitable for women with uterine problems and who are fit for surgical procedures. Your gynaecologist will carry out a thorough examination to check if you are eligible. This procedure is recommended for:

• Women without a prior history of cesarean section or extensive pelvic surgery.
• Any size of the uterus can be removed laparoscopically
• Even candidates with a previous cesarean section can have laparoscopic hysterectomy.
• Those who completed their family and do not require any more children, because the surgery ends a woman’s ability to conceive and bear children.
• Candidates with a healthy overall condition and no chronic health problems.

How Do You Prepare For Laparoscopic Hysterectomy Surgery?

After a full medical assessment, including blood, urine, and imaging tests, you will be given a scheduled appointment for the surgery. Follow the instructions from the surgical team about fasting and medication adjustments (if needed). You should fast for 8 hours before the procedure, as the procedure requires general anesthesia. No potable drinking water. You have to stop taking certain medicines, such as blood thinners and anticoagulants, several days before the date of surgery.

How Is Laparoscopic Hysterectomy Performed?

Your gynaecologist laparoscopic surgeon will perform the surgery under general anesthesia.

• They will inflate the abdomen using carbon dioxide. This is to gently inflate the stomach to create space and get better visibility.
• Your gynaecologist laparoscopic surgeon will make incisions near the belly button and pelvic areas.
• They will insert the apparatus into the abdomen for guided treatment. They will detach the uterus from surrounding tissues, dissect, and remove it.
• The surgeon will close the incision wounds using dissolvable sutures and cover them.

How Is Recovery After Laparoscopic Hysterectomy?

The procedure is minimally invasive with a shorter hospital stay of 1-2 days. While you return home, collect the post-op medications that include antibiotics and painkillers. It will take 1-2 weeks to get back to routine activities. However, the complete internal recovery will take 4-6 weeks. Focus on resting and taking short walks during the initial few weeks. Avoid strenuous exercises and sexual intercourse for a minimum 12 weeks until complete physical recovery.

What Are The Benefits Of Laparoscopic Hysterectomy?

Below, we listed all the benefits of getting this advanced approach for uterus removal:

• Involves smaller incisions
• Minimal scarring
• Shorter hospital stay
• Reduced blood loss and a lower infection risk
• Less painful and has a faster recovery than open surgery

How Is Life After Laparoscopic Hysterectomy?

Your life gets better, and you will feel relieved from the symptoms of heavy bleeding and chronic pain after getting a laparoscopic hysterectomy. The menstruation stops, and a woman can no longer bear children. Except for slight hormonal changes in case the ovaries are removed. There will be an overall positive impact on the emotional well-being.

Are There Any Risks And Complications From Getting A Laparoscopic Hysterectomy?

The procedure is generally safe when performed by a qualified, certified gynaec laparoscopic surgeon. Rare complications include bleeding (requiring transfusion), infection, injury to nearby organs, blood clots, and anaesthesia-related risks.

Is Laparoscopic Hysterectomy Painful?

Laparoscopic hysterectomy is generally less painful compared to the traditional open incision surgery. Modern techniques use sophisticated equipment to make smaller cuts. Cramping, soreness, and postoperative discomfort for the first few days of recovery. This will settle down when the cuts heal.

Will I Go Into Menopause After A Laparoscopic Hysterectomy?

This depends on whether your laparoscopic gynaecologist has removed your ovaries or not. Some patients require removal of the ovaries along with the uterus and cervix. This lets them enter a surgical menopause. However, some do not require ovary removal and continue to produce hormones. However, uterus removal will cut the blood supply to the ovaries, triggering an early menopause.

When Can I Return To Work After Laparoscopic Hysterectomy?

You may return to desk-based work after 2-4 weeks following laparoscopic hysterectomy. However, if the job requires extensive physical labor, it’s better to wait until 6-8 weeks. This will allow complete healing and reduce the risk of complications.

Will Laparoscopic Hysterectomy Cause Visible Scars?

The incisional scars after laparoscopic uterus removal are visible. But they are relatively less noticeable compared to the long abdominal cut caused by conventional surgery. Generally, the procedure causes 2-4 tiny, inch-sized incisions that appear as noticeable dots and fine lines.

When Should You Consult A Gynecologist?

You should attend the scheduled follow-up visits after laparoscopic hysterectomy. Don’t hesitate to see your doctor in case of persistent heavy bleeding, intense pelvic pain, and any unusual symptoms that affect the quality of life.