There are many opinions surrounding hysterectomy. Some women choose it. Others don’t. For women who do, a type of laparoscopic hysterectomy may be an option.
Hysterectomy, the surgical removal of the uterus, treats problems with the uterus, such as pain and heavy bleeding caused by endometriosis or fibroid tumors. It may also be used if there is cancer in the uterus, cervix or ovaries.
Laparoscopic hysterectomy is a surgical procedure done with a viewing instrument, called a laparoscope, and surgical instruments inserted through vaginal and abdominal incisions.
The types of laparoscopic hysterectomy are:
Laparoscopically assisted vaginal hysterectomy (LAVH). With LAVH, a doctor uses a laparoscope to guide the removal of the uterus through the vagina.
LAVH can also remove fallopian tubes and ovaries. On the flip side, it’s more expensive and takes longer to perform.
Laparoscopic supracervical hysterectomy (LSH). LSH is performed through one small incision in the base of the belly button and two smaller ones near the hip bones. The uterus is cut from its blood supply and the cervix, then cut into strips and removed through a tube.
This type of procedure usually causes minimal blood loss and pain. LSH can remove uterine fibroids or uteruses of any size.
Like LAVH, it costs more. There may be an increased risk of injury if the surgeon is inexperienced. LSH is a newer surgery that requires special training and isn’t available in some areas.
Total laparoscopic hysterectomy (TLH). TLH is performed solely through laparoscopes in the abdomen, starting at the top of the uterus. The entire uterus is disconnected from its attachments using long thin instruments. Then all tissue to be removed is passed through the small abdominal incisions.
TLH does not use an incision in the wall of the vagina.
This type is also more costly as TLH is a newer surgery and requires special training. It usually takes longer to do than abdominal or vaginal hysterectomy and is not available in many parts of the country.
Two other advantages of laparoscopic hysterectomy are smaller scars and faster recovery than abdominal or vaginal hysterectomy.
One disadvantage with any type of laparoscopic hysterectomy is it may need to be switched to an abdominal surgery if the doctor is unable to remove a very large uterus or areas of endometriosis, adenomyosis or scar tissue.
If laparoscopic hysterectomy has been suggested as an option for you, weigh the pros and cons, the alternative treatments, and the potential benefits and risks.
Dr. Deborah Wilson