Hysterectomy

Laparoscopic hysterectomy is a minimally invasive surgical procedure used to remove the uterus. This technique involves small abdominal incisions through which a laparoscope (a thin, lighted telescope) and specialized instruments are inserted. Compared to traditional open surgery, laparoscopic hysterectomy offers faster recovery, less pain, and minimal scarring.

Why is Laparoscopic Hysterectomy Performed?

This procedure is recommended for women experiencing:

• Uterine fibroids causing pain, bleeding, or pressure symptoms
• Endometriosis with severe pain or affecting fertility
• Adenomyosis leading to chronic pain and heavy bleeding
• Chronic pelvic pain unresponsive to other treatments
• Uterine prolapse (when the uterus descends into the vaginal canal)
• Gynecologic cancers (such as early-stage uterine or cervical cancer)
• Severe abnormal bleeding that does not improve with medications

Types of Laparoscopic Hysterectomy

• Total Laparoscopic Hysterectomy (TLH): Complete removal of the uterus and cervix.
• Laparoscopic-Assisted Vaginal Hysterectomy (LAVH): The uterus is removed vaginally with laparoscopic assistance.
• Subtotal (Supracervical) Hysterectomy: Removal of the uterus while preserving the cervix.
• Radical Laparoscopic Hysterectomy: Performed for cancer treatment, removing the uterus, cervix, and surrounding tissues.

Procedure Overview

Laparoscopic hysterectomy is performed under general anesthesia and typically takes 1.5 to 3 hours. The steps include:

1. Small incisions (typically 3-4) are made in the abdomen.
2. Carbon dioxide (CO₂) gas is introduced to expand the abdomen for better visualization.
3. A laparoscope and surgical instruments are inserted through the incisions.
4. The uterus is detached from surrounding tissues, and if necessary, the cervix, ovaries, or fallopian tubes are also removed.
5. The uterus is either removed vaginally or morcellated (broken into smaller pieces for extraction).
6. Incisions are closed with dissolvable sutures.

Benefits of Laparoscopic Hysterectomy

• Minimally Invasive: Small incisions reduce pain, scarring, and blood loss.
• Faster Recovery: Most women return to normal activities within 2-4 weeks (compared to 6-8 weeks for open surgery).
• Shorter Hospital Stay: Usually discharged within 24 hours.
• Lower Risk of Infection: Compared to open abdominal surgery.
• Less Postoperative Pain: Requires fewer pain medications.

What to Expect After the Procedure?

• Mild abdominal discomfort and bloating due to CO₂ gas
• Light spotting or vaginal discharge for a few weeks
• Fatigue for a few days, gradually improving
• No menstrual periods after the procedure (if ovaries are also removed, menopause may begin immediately)

When to Seek Medical Attention?

Contact your doctor if you experience:

• Severe or worsening abdominal pain
• Heavy vaginal bleeding or foul-smelling discharge
• Fever or chills (signs of infection)
• Leg swelling or shortness of breath (potential blood clot signs)

Conclusion

Laparoscopic hysterectomy is a safe, effective, and minimally invasive procedure for treating various uterine conditions. It provides significant relief from pain, bleeding, and other gynecological symptoms, allowing women to recover quickly and resume their daily lives.

For expert consultation, Dr. Apoorva Pallam Reddy offers advanced laparoscopic surgical techniques to ensure the best outcomes with personalized care.