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Laparoscopic Hysterectomy

What is a Laparoscopic Hysterectomy?

Laparoscopic hysterectomy is a minimally invasive surgery to remove the uterus. A small incision is made in the belly button to insert a tiny camera. The surgeon views the procedure on a monitor and uses specialized instruments inserted through two or three additional small incisions in the lower abdomen to perform the surgery.

Some women may choose to keep their ovaries during the procedure. Retaining the ovaries means no need for hormone replacement therapy or experiencing hot flashes. Ovaries may be removed due to family history of ovarian cancer or the presence of abnormal growths.

Women can opt to keep the cervix in place (a "laparoscopic supra-cervical hysterectomy") or have the entire uterus and cervix removed (a "total laparoscopic hysterectomy").

Keeping the cervix makes the surgery quicker and safer, but there’s a 5% chance of monthly spotting during menstrual periods. Women retaining the cervix should continue regular Pap smears.

To avoid menstruation entirely or in cases of pre-cancerous changes in the cervix or uterine lining, complete removal of the uterus is recommended. For endometriosis or pelvic pain, many doctors believe removing the cervix improves chances for pain reduction.

What are the advantages of Laparoscopic Hysterectomy?

Laparoscopic hysterectomy requires only small incisions compared to the larger incision of a traditional abdominal hysterectomy. This results in less blood loss, reduced scarring, and minimal post-operative pain. Most laparoscopic hysterectomies are outpatient procedures, with a recovery time of 1-2 weeks, compared to the 4-6 weeks needed after abdominal hysterectomy.

Risks of blood loss and infection are lower with laparoscopic hysterectomy. When performed by experienced surgeons, this procedure is as time-efficient and safe as abdominal hysterectomy.

Who is a good candidate for Laparoscopic Hysterectomy?

Laparoscopic hysterectomy is suitable for most patients undergoing hysterectomy for conditions like abnormal uterine bleeding or fibroids. However, it may not be possible in certain cases, such as when the uterus is as large as a 4-month pregnancy or if there have been multiple previous surgeries in the lower abdomen. It is generally not recommended for gynecologic cancer patients.