Total Laparoscopic Hysterectomy

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 it performed?

Total laparoscopic hysterectomy is done to treat conditions such as painful or heavy menstrual periods, pelvic pain, fibroids or may be performed as a part of cancer treatment. You should clearly understand the reason for this surgery.

Are there alternatives to this treatment?

There are other conservative interventions that may be appropriate for your particular condition. Hysterectomy may be performed vaginally, abdominally or laparoscopically. Laparoscopic hysterectomy has benefits such as shorter recovery period and reduced postoperative pain.

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 does not go away or is becoming worse. You should avoid heavy activities or exercise until you recover completely.

You may have some vaginal discharge for several days after the procedure. You can return to normal activity by three months, but complete recovery may take longer time. After the procedure, you will no longer be menstruating or be able to conceive. You may experience bladder and bowel dysfunction and an increased risk of urogenital prolapse.

What are the possible risks and complications of this procedure?

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

  • Problems with anaesthesia
  • Injury to internal organs
  • Bleeding and infection

Any specific risks and complications will be discussed prior to the procedure.

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
RANZCOGCalvary John James HospitalCanberra HospitalAustralian  National UniversityWomens HealthICS