Laparoscopic Hysterectomy
Definition
A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus using small abdominal incisions and a camera (laparoscope).
Types
- Total Laparoscopic Hysterectomy (TLH) – removal of uterus and cervix
- Subtotal (Supracervical) Hysterectomy – uterus removed, cervix left behind
- Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) – part laparoscopic, part vaginal
- Radical Hysterectomy – includes surrounding tissues (usually for cancer)
Indications
- Uterine Fibroids
- Endometriosis
- Adenomyosis
- Abnormal Uterine Bleeding
- Uterine Cancer
- Chronic pelvic pain
- Uterine prolapse
Contraindications (Relative)
- Very large uterus
- Severe adhesions from previous surgeries
- Advanced malignancy
- Poor surgical fitness
Procedure (Step-by-step)
- Patient under general anesthesia
- Small incisions (usually 3–4) in abdomen
- Carbon dioxide gas used to inflate abdomen
- Laparoscope inserted for visualization
- Uterus separated from ligaments and blood supply
- Removal via vagina or small incision
- Closure of incisions
Advantages
- Smaller incisions
- Less pain
- Shorter hospital stay (1–2 days)
- Faster recovery
- Minimal scarring
- Less blood loss
Disadvantages / Risks
- Injury to bladder, bowel, or ureter
- Bleeding
- Infection
- Conversion to open surgery (rare)
- Anesthesia-related risks
Postoperative Care
- Early mobilization
- Pain management
- Avoid heavy lifting for 4–6 weeks
- Follow-up visits
- Monitor for fever, bleeding, or infection
Recovery Time
- Usually 2–4 weeks (faster than open surgery)
Complications
- Hemorrhage
- Infection
- Deep vein thrombosis
- Organ injury
