Laparoscopic Hysterectomy

A hysterectomy is the second most common surgery women undergo each year. The easiest form is a laparoscopic hysterectomy. This is a relatively new procedure that physicians use to remove the uterus through a small incision made at the top of the vagina. In other words, it requires no open abdominal incision and no long recovery time. During a laparoscopic hysterectomy the doctor uses a small camera that is attached to a telescope inside the body to see the uterus, fallopian tubes and ovaries.

One advantage of the procedure is that the incisions are small and the recovery is very quick. The hospital stay is usually around 1 day as opposed to an abdominal hysterectomy which requires 2 days in the hospital. Women who undergo laparascopic surgery will also be back to their normal activities within 2 weeks instead of the usual 6 weeks estimated for an abdominal hysterectomy.

During a laparoscopic procedure the surgeon can release the blood vessels and the uterus before removing the uterus through the vagina. This will prevent the potential damage to the bladder and intestines if the uterus has been damaged from endometriosis or pelvic scar tissue.

Laparoscopic hysterectomy also requires a considerable amount of skill and experience on the part of the surgeon. When a laparoscopic hysterectomy is performed, the cervix may not also be removed. Prior to 1940 the cervix was always removed during a hysterectomy in order to prevent cervical cancer. However, today physicians recognize the structural stability which the cervix plays in support of the ureters, bladder and intestines. Since 1940 there have been improvements in the techniques used to treat and diagnose cervical cancer such as antibiotic use, Pap smears and anesthesia changes. This means that removal of the cervix is no longer essential for all women.

Each year approximately 650,000 women nationwide will undergo a hysterectomy for a variety of different \”female\” problems that include abnormal heavy bleeding, fibroids, chronic pelvic inflammatory disease, ovarian cancer and endometriosis. The laparoscopic procedure was pioneered by a gynecologist in the early 1960s who used it in a range of conditions such as tubal ligations, removal of the ovaries and fibroids in the treatment of tubal pregnancies. Laparoscopy is also used by physicians in other fields to remove or repair gallbladder, appendix, hernias and on surgeries in the lungs, bowel and bladder.

Preparation for a laparoscopic hysterectomy is simple and requires only a physical examination by the primary care physician to clear the woman for anesthesia and that she not eat anything after midnight the night before. Women will have a shorter recovery time and will be able to resume sexual activity more quickly than with an abdominal approach.

Unfortunately no matter how the surgical procedure is performed, the woman will continue to have the same side effects of any woman who has a hysterectomy. These side effects include early menopause and symptoms such as hot flashes, vaginal dryness and decreased sexual drive. Some treatment options for these symptoms are natural and others require medications from your physician. The best option for any woman is to start with a natural treatment and move towards pharmaceutical medications. This helps to decrease the number of side effects a woman will experience from the different treatment options she will use. For instance, some women find significant relief from their hot flashes by changing their nutritional intake and paying attention to their external environment.

A laparoscopic hysterectomy approach will help to decrease recovery time, decrease costs and decrease surgical risk for women who must undergo a hysterectomy for treatment of their underlying medical conditions. Discuss your total options with your primary care physician and surgeon so that you are able to make the best informed choice possible.

RESOURCES

Reviews in Obstetrics and Gynecology: Total Laparoscopic Hysterectomy

Johns Hopkins Medicine: Laparoscopic Hysterectomy

The American College of Obstetricians and Gynecologists: Hysterectomy