Minimally Invasive Hysterectomy
In the past, open surgical hysterectomies resulted in hospital stays of several days, pain, a lengthy recovery time and a large abdominal scar. Now, minimally invasive surgical techniques result in hysterectomies that eliminate many of the disadvantages of traditional open surgical procedures.
A minimally invasive hysterectomy performed in a hospital setting, can treat and correct conditions such as:
- chronic pelvic pain
- uterine fibroids
- abnormal uterine bleeding
- uterine prolapse
- cervical abnormalities
Minimally invasive hysterectomies using laparoscopic techniques are unlike open surgeries because they are performed through one or more small incisions. These procedures may also allow more women, who may not be candidates for open surgery, have a hysterectomy.
Laparoscopic surgical procedures used in minimally invasive hysterectomies
- use fiber optics (laparoscope) and a miniature television camera along with specialized instruments are inserted into very small incisions in the navel and abdomen or through the vagina
- may be exploratory while others are used to remove appropriate reproductive organs
- may utilize robotic devices like the da Vinci Surgical System that permits surgeons to perform with extremely high precision, vision and a level of control unavailable with standard laparoscopic procedures.
Approaches and treatments depend upon factors such as obesity, prior abdominal surgery, scar tissue and other medical considerations.
Types of minimally invasive laparoscopic hysterectomy procedures
- Laparoscopically Assisted Vaginal Hysterectomy (LAVH). Surgeons use special laparoscopic instruments to remove the uterus and, if necessary, the fallopian tubes and ovaries. By operating through the vagina, the cervix is separated from the top of the vagina permitting the uterus and the cervix to be removed through the vaginal opening.
- Laparoscopic Supracervical Hysterectomy (LSH). The LSH procedure is done to remove the upper two thirds of the uterus using laparoscopic instruments inserted through small incisions in the abdomen. By leaving the cervix intact and attached to the upper vagina, this procedure helps to provide better post-operative vaginal support and eliminates the need for the vagina to heal. Using specials instruments, the uterus is then removed through the small incisions in the abdomen.
- Total Laparoscopic Hysterectomy (TLH) . Using similar incisions to a Laparoscopic Supracervical Hysterectomy, a TLH involves removing both the cervix and the uterus. Unlike a Laparoscopic Assisted Vaginal Hysterectomy, a very limited portion of the TLH procedure is done through the vagina.
A vaginal hysterectomy:
- is a surgical procedure that is performed in a hospital
- involves removing the uterus surgically through the vagina
- is performed if the uterus is not greatly enlarged
- is performed if the medical conditions are not related to cancer
- has fewer complications, requires a shorter hospital stay, and allows a faster recovery when compared to the removal of the uterus through an abdominal incision (abdominal hysterectomy)
- can be used to remove one or both ovaries as well as fallopian tubes. This procedure is called a bilateral salpingo-oophorectomy (BSO).
Some surgeons perform a laparoscopically assisted vaginal hysterectomy (LAVH) to assist with the vaginal hysterectomy procedure. This is done because the use of a laparoscope helps the surgeon to more easily see the uterus, ovaries, and tissues that surround these organs.