Laparoscopic Hysterectomy, also known as Lap Hysterectomy, is a minimally invasive surgical procedure that is done to remove the uterus. It offers the advantages of shorter hospital stay, faster recovery, early resumption of activities, and lesser complications when compared to traditional and open surgical procedures for hysterectomy.
Laparoscopic Hysterectomy is an elective procedure.
Lap Hysterectomy may be of the following types:
Some indications for Lap Hysterectomy include the following conditions:
Some contraindications for Lap Hysterectomy include the following:
Some investigations that may be done before Lap Hysterectomy include:
Before the surgery, the following are done:
Duration: A Lap Hysterectomy may last between 1-3 hours depending on the procedure that is being performed.
Anesthesia: Laparoscopic Hysterectomy surgery is done under general anesthesia with intubation and epidural anesthesia for postoperative pain management.
With the individual lying on her back and the thighs slightly flexed, IV lines and the endotracheal tube are put in place, and after the general anesthetic has taken effect, a speculum is placed in the vagina and the cervix is dilated. Multiple incisions are given in the abdomen, and the abdomen is insufflated. The laparoscope is introduced through the incision near the umbilicus, and the other surgical instruments are introduced through the remaining incisions.
The ligaments (round ligament and infundibulopelvic ligaments, and blood vessels (uterine vessels) attached to the uterus are coagulated, sectioned, and ligated. The uterus is then removed after freeing it from all its attachments in the pelvis. The uterus is removed through a small incision in the vagina if a vaginal hysterectomy is being done. If a laparoscopic supracervical hysterectomy is being done, a portion of the cervix is left behind. Depending on the procedure that is being done, the ovaries, the cervix, lymph nodes, and surrounding tissue may also be removed.
Care is taken to avoid injury to the urinary bladder and other important structures inside the pelvis. Abdominal insufflation is done and the instruments are removed after confirming that there is no residual bleeding. The abdominal incisions are closed with absorbable sutures.
After the surgery, the following are done:
Common post-procedure occurrences are:
Discharge: Usually on the 2ndpostoperative day if there are no complications.
Medications: Pain relievers and antibiotics may be prescribed.
Review: Usually 1 week after the procedure and regular check-ups thereon.
Resumption of normal activity: Usually 2- 3 weeks after the procedure.
Some measures that are taken after a total Laparoscopic Hysterectomy surgery include:
Some complications that may be seen with surgery include:
The prognosis of the surgery is generally excellent with faster recovery, shorter hospital stay, and less postoperative complications, although it also depends on the underlying condition that is being treated.
Brief hospitalization will be required.
It is done by specialists from the department of advanced laparoscopic gynecologic and obstetric surgery.