Total Laparoscopic Hysterectomy: A Less Invasive Approach
Leesa Kaufman, MD, is with Lifestages—Samaritan Centers For Women. Lifestages has offices in Dayton, Englewood, Huber Heights and Trotwood. Dr. Kaufman is board-certified in obstetrics and gynecology.
What are some of the reasons a woman might need a hysterectomy?
Dr. Kaufman: A life-threatening disease such as cancer may require a hysterectomy. In addition, uterine fibroids (benign growths in the wall of the uterus), endometriosis (cells from the lining of the uterus growing outside the uterus) and uterine prolapse (inadequate pelvic support for the uterus) are common reasons your doctor might recommend a hysterectomy. More than a fourth of all women in the United States will have a hysterectomy by the time they are 60.
Are there different approaches to hysterectomy surgery?
Dr. Kaufman: Depending on your medical condition, your doctor may advise removing only your uterus, your uterus and cervix, or perhaps your uterus, cervix, ovaries and fallopian tubes.
What about the procedure itself – how is it done?
Dr. Kaufman: In the past, a hysterectomy involved a hospital stay of several days, a lengthy recovery time, limited post-operative activity and either a large abdominal incision or surgery done through the vagina.
Today, we have minimally invasive techniques using tiny instruments inserted through incisions ¼ inch or less in length. We insert a miniature video camera (laparoscope) through one of these incisions so that we can see the surgical area on a large monitor. After the organs to be removed are disconnected from the connective tissue that holds them in place, they can be removed through the vagina or through the small abdominal incisions. Compared to older methods, minimally invasive hysterectomy causes less pain, requires a shorter hospital stay, and results in faster recovery and a smaller scar.
What is TLH – total laparoscopic hysterectomy – and what are its advantages?
Dr. Kaufman: TLH requires state-of-the art instruments as well as a great deal of surgical skill and precision. This procedure is not available everywhere. Lifestages’ surgeons are trained and experienced in TLH.
In a total laparoscopic hysterectomy, the entire procedure is done through several small abdominal incisions. Organs are removed in pieces through these incisions or passed through the vagina. TLH patients usually go home the same day or stay overnight in the hospital and are often back to a normal routine in one to two weeks.
No matter what type of hysterectomy you are considering, it is important to remember that a hysterectomy is major surgery and, in the vast majority of cases, should be pursued only if you cannot be treated with or have not had success with other approaches. Your doctor will help you understand your options and select the procedure that is right for you.