Laparoscopic hysterectomy

Laparoscopic Hysterectomy

Overview

Laparoscopic hysterectomy is a minimally invasive surgical procedure to remove a woman’s uterus (womb) through small incisions in the abdomen using a laparoscope—a thin tube with a camera and light. In some cases, the ovaries and fallopian tubes may also be removed, depending on the underlying medical condition and patient preferences.

A specific type, called laparoscopic supracervical hysterectomy (LSH), involves removing the uterus while preserving the cervix, the lower part of the uterus.

After undergoing a hysterectomy, a woman will no longer menstruate and cannot become pregnant.

Indications for Hysterectomy

Your doctor may recommend laparoscopic hysterectomy for the following conditions:

• Uterine fibroids
• Endometriosis that hasn’t improved with medical or prior surgical treatment
• Uterine prolapse (uterus descends into the vagina)
• Cancer of the uterus, cervix, or ovaries
• Abnormal vaginal bleeding unresponsive to other treatments
• Chronic pelvic pain affecting quality of life

Pre-Surgical Evaluation

Before surgery, your doctor may conduct several diagnostic tests, including:

• Pelvic ultrasound: To evaluate the uterus and ovaries using high-frequency sound waves
• Pap smear: To detect precancerous or cancerous cervical cells
• Endometrial biopsy: Sampling of the uterine lining to detect abnormal or cancerous changes

Surgical Procedure

• Anesthesia: General anesthesia is administered.
• Incisions: 3–4 small incisions are made in the abdomen, often near the belly button.
• Laparoscope insertion: A camera-equipped laparoscope is introduced to view internal organs on a monitor.
• Tissue dissection: Surgical instruments detach the uterus from surrounding tissues and ligaments.
• Uterus removal: The uterus is removed in sections through the small incisions. The cervix is preserved in LSH.
• Closure: Incisions are closed with sutures, and a sterile dressing is applied.

Ovaries and fallopian tubes may be removed or retained, depending on age, condition, and patient consent.

Benefits of Laparoscopic (Minimally Invasive) Hysterectomy

• Smaller incisions and less visible scarring
• Reduced pain after surgery
• Lower risk of infection
• Faster recovery and shorter hospital stay
• Minimal blood loss
• Most cases performed as day-care (outpatient) surgery

Postoperative Care

Recovery depends on the type of hysterectomy and the patient's healing progress. Key post-op guidelines include:

• Pain medications and antibiotics will be prescribed.
• Avoid lifting heavy objects or strenuous activity.
• Resume light activities once discomfort and bleeding subside.
• Sexual activity may be resumed after 6 weeks (upon doctor’s advice).
• Avoid exercise or abdominal strain for at least 3 weeks post-surgery.

Possible Risks and Complications

Although rare, risks associated with laparoscopic hysterectomy include:

• Infection or bleeding
• Blood clots
• Bladder or ureter injury
• Urinary incontinence
• Vaginal prolapse
• Painful intercourse
• Chronic pelvic pain
• Early menopause if ovaries are removed

When to Contact Your Doctor

Seek immediate medical attention if you experience:

• Heavy vaginal bleeding
• Fever above 101°F (38.3°C)
• Severe abdominal pain
• Redness, swelling, or discharge at the incision site
• Persistent nausea or vomiting
• Shortness of breath