
The total laparoscopic hysterectomy (TLH) offers women an option that is far
less invasive than other surgical approaches. The need for a hysterectomy is an
important and difficult decision.
The surgical removal of the uterus can be lifesaving for those suffering from
gynecological cancers or the severe pain and heavy bleeding due to fibroids or
endometriosis.
Today, there are several surgical approaches that are far less invasive than a
total abdominal hysterectomy, which is still widely performed. Using a
laparoscope — a slender, fiber-optic tube equipped with a miniature camera,
lights and surgical instruments — surgeons have the ability to see inside the
abdomen and technical access to the uterus, ovaries and fallopian tubes without
having to make a large incision.
In the past few years, many gynecologists have performed a portion of the
hysterectomy using a laparoscope. Called a laparoscopically assisted vaginal
hysterectomy (LAVH), the procedure requires an incision deep within the vagina,
through which the uterus and related organs are removed. The LAVH still involved
a transvaginal approach and decreased healing time, similar to a total vaginal
hysterectomy.
With advanced laparoscopic skills, gynecological surgeons are able to perform
TLH. The surgery is completed utilizing only four tiny abdominal incisions less
than one-quarter to one half an inch in length. Even a large uterus can be
removed laparoscopically using this technique. A traditional open hysterectomy
requires an abdominal incision of four to eight inches.
Post surgically, patients have a much quicker recovery, usually going home the
same day or stay one overnight in the hospital. Often, patients are able to
return to their normal routine in one to two weeks. Patients report less pain,
minimal post-surgical narcotic pain medication use, and a faster recovery time
than women undergoing abdominal hysterectomies who usually require a three to
four day hospitalization and lengthy recovery time of usually six to eight
weeks.
The majority of hysterectomies are performed for benign tumors or conditions
that allows women a choice of a variety of alternative treatments for fibroids,
endometriosis and uterine prolapse.
