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What is Laparoscopic Hysterectomy?

A laparoscopic hysterectomy is a type of hysterectomy that is carried out through a small incision in the abdomen or vagina. This can be a less invasive procedure with shorter recovery times than other strategies, such as abdominal hysterectomies. However, it is still a daunting prospect for anyone who requires the procedure. For that reason, it always helps to try and gain a fuller understanding of the procedure, how it works, and why it is being carried out in that way. With this information, you can better rationalize the process and stay calm and comfortable as is possible.

How it Works

During a laparoscopic hysterectomy, the organs and surrounding tissues of the reproductive system are removed through small keyhole surgery. This helps to minimize the damage to surrounding tissue, leaves a smaller scar, and ultimately improves recovery times.

The term “laparoscope” refers to the tiny telescope-containing-tube that is inserted through a small incision in the stomach. This scope is used in order to provide the surgeon with a visual so that they can clearly see what they are doing while they work. This means that they don’t need to peel back a large fold of skin to gain access.

The surgeon will then make another incision that will be placed either in the abdomen or the vagina. They will then be able to use surgical instruments – with guidance from the footage from the laparoscope – in order to carefully remove the womb, cervix, and other parts of the reproductive system as deemed necessary for improved health.

While the incisions made are small, most patients will be placed under general anesthetic during the procedure. This means that you won’t feel any discomfort during the process itself, and the first thing you’ll know about it is when you wake up!

Your Other Options

If the surgeon elects to use another procedure, it may be a vaginal hysterectomy or an abdominal hysterectomy.

In the case of a vaginal hysterectomy, the womb and cervix are removed via an incision that is made at the top of the vagina. This will be slightly larger than the incision made in a laparoscopic procedure. Surgical instruments will be inserted into the vagina with the intention of detaching the womb from the ligaments holding it in place. Once these have been removed the incision is sewn up. This process will normally last about one hour.

Often you will be placed under general anesthetic, though it is also possible that you may receive a local anesthetic or spinal anesthetic instead.

The third option is the abdominal hysterectomy. This surgery is carried out via an incision in the abdomen, which is usually larger and thus requires more recovery time than either of the other two options. The abdominal hysterectomy will therefore only usually be considered if there is something blocking access via the other routes. Examples include large fibroids (which are non-cancerous growths) that are in the womb.

Once the womb is removed, the incision will be stitched closed. This takes about an hour and general anesthetic will always be used.

Types of Hysterectomy

Hysterectomies vary depending on the precise procedure then, but they also vary based on what is being removed. A subtotal hysterectomy is a hysterectomy that removes only the main body of the womb, thus leaving the cervix in place. This is not a common operation, as the cervix may risk cancer if it is left and cervical screening might be necessary.

However, if the reason for operation is not cancer-related, some women will ask to keep as much of their reproductive system as possible. You should flag this up with your surgeon if you feel this way.

You might also receive a total hysterectomy with “bilateral salpingo-oophorectomy.” In this process, the fallopian tubes are removed along with the ovaries on top of the cervix and the womb. This is generally only recommended where there is a risk of ovarian cancer or other complications that specifically affect the ovaries.

Radical hysterectomies are normally used to remove and treat cancer when other approaches – such as chemotherapy or radiotherapy prove ineffective. This will remove a large proportion of the reproductive system:

  • Fallopian tubes
  • Part of the vagina
  • Ovaries
  • Lymph glands
  • Fatty tissue
  • Womb
  • Cervix

Why Hysterectomy

If you have been recommended for a hysterectomy, that will usually be due to one of several reasons:

  • Heavy periods – often caused by fibroids (and so necessitating an abdominal procedure in many cases)
  • Pelvic pain, potentially caused by endometriosis
  • Prolapse of the uterus
  • Cancer of the womb, the ovaries, or the cervix

Women who experience very heavy periods can find this to be extremely uncomfortable and may be unable to engage in their usual activities during this time. Not only can this be a cause of distress, but it may also be dangerous if very large amounts of blood are lost.

Some women will, therefore, choose to have their womb and cervix removed if they do not intend to have children. This can improve quality of life, though it is important to recognize that it may also have other side effects including hormonal.

For these reasons, it is highly important to discuss the subject with a physician thoroughly.

In the case of diseases such as cancer, surgery will usually be the last option. If other treatments such as radiotherapy are effective in destroying the cancerous cells, then this can avoid the need for a hysterectomy. However, if a physician believes that this is the best course of action, then it will always be in the patient’s best interest.

Recovery

Recovery times can vary depending on the precise procedure and the individual. However, you will usually find that you are required to stay in the hospital with a drainage tube in your abdomen for 1-2 days following the procedure. You will also use a catheter during this time, which is a small tube that drains urine from the bladder into a bag.

A gauze pack will minimize bleeding for the first 24 hours. Stitches are normally removed 5-7 days after the operation.