Total Laparoscopic Hysterectomy (TLH)
Overview
This minimally-invasive procedure is used to remove both the uterus and the cervix through small incisions in the abdomen.
Preparation
Anesthesia is administered, the patient is positioned, and the abdomen is cleaned, sterilized, and inflated with carbon dioxide gas. The gas creates working space for the surgeon's instruments. The surgeon's assistant inserts a uterine manipulator into the vagina, allowing the uterus to be moved and positioned as needed.
Accessing the Abdomen: Traditional
In a traditional open hysterectomy, a large incision, typically 6-8 inches in length, is made in the abdomen. This is commonly referred to as a bikini line incision.
Accessing the Abdomen: Laparoscopic
A series of small incisions are created on the abdomen. The surgery will be performed through these tiny holes, rather than the large incision traditionally used for open surgery. This approach minimizes pain, scarring, risk of infection, and recovery time.
Laparoscope Inserted
The surgeon inserts a laparoscopic camera through the large incision near the navel. A video monitor, which is linked to the laparoscope, allows the surgeon to view the surgical site on a monitor.
Instruments Inserted
Specialized surgical instruments are inserted through the incisions. These instruments are designed for extremely precise movements when guided by the surgeon and can safely and easily grasp, cut, cauterize and remove tissue.
Removing the Reproductive Organs
The surgeon carefully detaches the uterus and cervix. They are carefully pulled out of the body through the vagina. Other reproductive structures, such as the fallopian tubes and ovaries, may also be removed. The top of the vagina is then closed with sutures.
End of Procedure and Recovery
The instruments are removed from the abdomen, and the incisions are closed and bandaged. The patient may go home the same day or have up to a one day stay in the hospital. Recovery time is usually up to 2-3 weeks, which allows patients to return to normal activity quicker than traditional hysterectomy. Open hysterectomies require a hospital stay of up to five or six days and a recovery of up to six weeks. If your ovaries are also removed, it may lead to symptoms associated with menopause (hot flashes, insomnia, irritability or vaginal dryness). These symptoms may be reduced by alternative therapies. Ask your physician about your options.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.