Total Laparoscopic Hysterectomy

A hysterectomy is a major surgery to remove your uterus or womb. In a total hysterectomy, the cervix, which is the lower part of the uterus near the vagina, is also removed.

WHAT IS TOTAL LAPAROSCOPIC HYSTERECTOMY?

Total laparoscopic hysterectomy is a surgical procedure for the removal of the uterus.

In this technique, the uterus is separated from the adjacent structures and removed in small pieces through small incisions or through the vagina.

A hysterectomy is a major surgical procedure and has both psychological and physical consequences.

WHY IS A HYSTERECTOMY PERFORMED?

Your doctor may recommend a total laparoscopic hysterectomy is done to treat conditions such as:

• Painful or heavy menstrual periods,
• Irregular, heavy or very long periods
• Chronic pelvic pain (after other possible causes have been ruled out).
• Fibroids
• Cancer of the uterus, cervix, endometrium or ovaries
• Non-cancerous tumours in your uterus
• Endometriosis - when the lining of your uterus grows outside the uterus
• Incontinence, pelvic pressure or difficulty with bowel movements

Your doctor may recommend a hysterectomy if you have not improved with other treatments.

TYPES OF HYSTERECTOMY

Hysterectomy surgery may be:

• abdominal - your uterus is removed through a cut in your lower abdomen
• vaginal - your uterus is removed through your vagina
• laparoscopic - instruments are passed through small incisions in and near your belly button.

Laparoscopic hysterectomy has benefits such as shorter recovery period and reduced postoperative pain.

Depending on your medical problem, your doctor may recommend you also have your cervix, ovaries or fallopian tubes removed.

You should clearly understand the reason for this surgery and discuss with your doctor the best type for you.

ARE THERE ALTERNATIVES TO A HYSTERECTOMY?

Unless you have cancer, your doctor will probably recommend other treatments, such as medicines or other surgical procedures, first.

There are other conservative interventions that may be appropriate for your particular condition.

HOW IS A LAPAROSCOPIC HYSTERECTOMY PERFORMED?

The procedure is done under general anaesthesia in the operating room. A small incision is made just below your umbilicus.

The abdomen is inflated with gas and a fibre-optic instrument called a laparoscope is inserted to view the internal organs.

Further small incisions may be made on your abdomen through which tiny surgical instruments are passed. Then the uterus and cervix are removed along with or without both ovaries and tubes.

WHAT PRECAUTIONS SHOULD BE TAKEN BEFORE THE PROCEDURE?

You can continue taking your regular medications unless your doctor advises.

You may need to have a bowel preparation which will empty your bowel before the surgery. For this, you should be on a liquid diet (soups, jellies, juices or similar drinks) for 24 hours before the surgery.

Avoid smoking and if you develop signs of illness prior to your surgery, please contact our office immediately.

WHAT CAN BE EXPECTED DURING THE RECOVERY PERIOD?

You will be in the recovery room when you wake up from anaesthesia. You may feel sleepy for the next few hours. You may have pain in the shoulder or back which is because of the gas used in the procedure. It resolves within a day or two.

You may have some discomfort or feel tired for a few days after the procedure. Contact your doctor if pain and nausea do not go away or is becoming worse.

You'll be in the hospital for at least a day or two, and perhaps up to seven days.

AFTER YOUR HYSTERECTOMY IS PERFORMED

After your procedure, you may experience

• vaginal bleeding and discharge for up to a few weeks after surgery.
• bladder and bowel dysfunction, and
• an increased risk of urogenital prolapse.

You may also find

• standing for long periods can also be tiring
• lifting heavy objects or do anything strenuous difficult for at least a few weeks.
• returning to normal activity can take a few months, and
• complete recovery may take longer time.

You should contact your doctor if pain worsens or if you develop nausea or vomiting, or bleeding that's heavier than a menstrual period.

WHAT ARE THE POSSIBLE RISKS AND COMPLICATIONS OF THIS PROCEDURE?

As with any surgical procedure, there are associated risks and complications which include:

• heavy bleeding
• infection
• You may experience effects from the anaesthetic.

These should be discussed with your doctor.

Pregnancy After a Total Hysterectomy?

After the procedure, you will no longer be menstruating or become pregnant after you've had a hysterectomy, so you have to be completely sure that you'll never want to become pregnant before you have one.

Post Hysterectomy Recovery

Some women find a hysterectomy very difficult emotionally, worrying that they have lost something important about being a woman. Others find they feel much better, especially if symptoms like heavy bleeding have gone.

WHAT IF I COME ACROSS ANY PROBLEM DURING THE RECOVERY PERIOD?

You should seek immediate medical attention if you experience any of these conditions:

• Fever
• Offensive vaginal discharge or heavy bleeding
• Severe nausea or vomiting
• Inability to empty your bladder or bowels
• Severe pain