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Laparascopic Uterosacral Ligament Excision

What Is A Laparoscopic Uterosacral Ligament Excision?

Laparoscopic Uterosacral Ligament Excision or ablation therapy (also called as LUNA) is a minimally invasive surgical procedure in which uterosacral ligaments and uterosacral nerves are excised.

Advanced Laparoscopy or Ablation Therapy is used to relieve the symptoms of chronic pelvic pain.

What Conditions Does the Laparoscopic Uterosacral Ligament Excision Surgery Help?

The Laparoscopic Uterosacral Ligament Excision can help in cases of chronic pelvic pain caused by a number of disorders such as

Why is Laparoscopic Uterosacral Ligament Excision Surgery Required?

Chronic pelvic pain can be severely debilitating and can significantly reduce the quality of life of women suffering from it.

This surgical approach offers a number of benefits, chief among them are:

  • smaller incisions which are minimally invasive,
  • less bleeding,
  • quicker recovery times, and
  • shorter hospital stays.

The surgery is completed using only three or four small keyhole incisions, resulting in a better cosmetic result. The procedure compares favourably with outcomes using an open surgery approach.

Who is the Laparoscopic Uterosacral Ligament Excision Surgery Suitable For?

Advanced laparoscopy is a suitable procedure option for anyone who is in good health and no other comorbidities that may exclude the patient from this procedure.

Preparation Before the Laparoscopic Uterosacral Ligament Excision Surgery

The doctor then runs a number of tests to ensure that the patient is fit and in good health for the surgery.

After a thorough physical examination, other preparations for Ablation Therapy can include:

  • Blood pathology tests,
  • Urine analysis, and
  • CT Scans.

Advanced Laparoscopy is major surgery and the patient is advised not to eat anything for eight hours before the procedure.

Some hospitals may keep the patient overnight before surgery.

Day of Laparoscopic Uterosacral Ligament Excision Surgery

This procedure is carried out under general anesthesia, which means the patient will be fully unconscious during the surgery.

The entire procedure is completed in one to three hours

Before surgery

  • An IV line is passed into the patient’s arm to push fluids as needed,
  • After sedation, the abdomen is inflated to make space for surgery,

The surgical procedures include the following steps:

  • The uterosacral ligaments are stretched with the aid of a uterine manipulator, which places the uterus in an anteverted position,
  • Keyhole surgical incisions are made and a camera (telescope) and laparoscopic surgical instruments are inserted into the distended abdominal cavity via the incisions (ports),
  • The surgeon uses the surgical tools and the camera to locate and excise or ablate the uterosacral ligaments from the uterus,
  • Stitches or staples are used to close the primary incisions,
  • The surgeon may place a drain as a precaution before closing (later removed),

The patient is brought out of anesthesia and placed in a post-operative care unit.

Immediately After the Laparoscopic Uterosacral Ligament Excision Surgery

The patient is kept in the recovery room for observation and the vitals are monitored.

A catheter may be used to ensure an easier flow of urine while the patient recovers.

NSAIDs and paracetamol are given for pain management.

The patient may be moved to a room in a few hours, and she can begin to take liquids by evening.

If a drain was placed in the abdomen by the surgeon, it will be removed once no discharge is seen in the collection bag.

An average hospital stay after this surgery is expected to be one day. 

What Should I Expect After Ablation Surgery?

The doctor will devise a care plan for the patient and request follow-ups, several weeks apart.

The patient is also given a leaflet with information regarding post-operative care and she can ask his doctor any questions that he may have.

Stages of Recovery after the Laparoscopic Uterosacral Ligament Excision surgery

Recovery after surgery requires keeping the sutures clean and changing bandages as needed. Paracetamol can also be taken on an as per need basis.

The patients are expected to return to normal life within 10 days. Complete recovery normally requires four to six weeks.

Possible Risk or Complications of the Laparoscopic Uterosacral Ligament Excision?

Possible risk of side effects exists with any surgery.

Advanced Laparoscopy or Ablation Therapy complications can include:

  • bleeding, and
  • the loss of support for the uterus, which can lead to uterine prolapse in very rare cases.

Ureteral injury due to an improper technique used during the procedure is also a risk.