All you need to know about Laparoscopic Hysterectomy – Blog

Before we get to understand Laparoscopic Hysterectomy, lets understand what is Hysterectomy and why it is recommended.

A hysterectomy is the surgical removal of the uterus, and most likely, the cervix (neck of the womb). Depending on the reason for the surgery, a hysterectomy may involve removing surrounding organs and tissues, such as the Fallopian tubes and ovaries.

The uterus is where a baby grows during pregnancy. It’s lining is the blood you shed during your menstrual period. You lose the ability to get pregnant and you will not get your period after a hysterectomy.

Why Hysterectomy is needed?

There are common reasons for having a hysterectomy.

Illustration showing the womb and surrounding structures. — The womb and surrounding structures.

Abnormal or heavy vaginal bleeding that is not controlled by other treatment methods.
Severe pain with menses that is not controlled by other treatment methods
Leiomyomas or uterine fibroids (noncancerous tumors).
Increased pelvic pain related to the uterus but not controlled by other treatment.
Uterine prolapse (uterus that has “dropped” into the vaginal canal due to weakened support muscles) that can lead to urinary incontinence or difficulty with bowel movements.
Cervical or uterine cancer or abnormalities that may lead to cancer for cancer prevention.
Conditions with the lining of your uterus like hyperplasia, recurrent uterine polyps or adenomyosis.

A hysterectomy may cure or improve your symptoms. You will no longer have periods.

How common is hysterectomy in India?

In India, the prevalence of hysterectomy operation was 3.2%, the highest in Andhra Pradesh (8.9%) and the lowest in Assam (0.9%). Rural India had higher a prevalence than urban India.

Are there any alternatives to a hysterectomy?

Symptoms may be improved by doing pelvic floor exercises.
Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications. Other alternatives include an IUS or ‘conservative surgery’ where only the lining of your womb is removed (endometrial resection).
Depending on the size and position of fibroids, you can take medication to try to control the symptoms. Other treatments include surgery to remove the fibroids only.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible. The operation usually takes about 90 minutes.

Your gynaecologist will make a small cut, usually on or near your belly button, so they can insert an instrument in your abdominal cavity to inflate it with gas (carbon dioxide). They will make several small cuts on your abdomen so they can insert tubes (ports) into your abdomen. Your gynaecologist will insert surgical instruments through the ports along with a telescope so they can see inside your abdomen and perform the operation.

Your gynaecologist may need to place instruments through your vagina to help them remove your womb.

They will make a cut around your cervix at the top of your vagina so they can remove your womb and cervix.

How is Laparoscopic hysterectomy performed?

A laparoscope (a thin tube with a video camera on the end) is inserted in the lower abdomen through a small incision in the belly button.
Surgical tools are inserted through several other small incisions.
Your uterus can be removed in small pieces through the incisions in your abdomen or through your vagina.
In most cases the patient is discharged after 2 or 3 days of the procedure
Full recovery is shorter and less painful than an abdominal hysterectomy.

How long does a hysterectomy procedure last?

The procedure lasts one to three hours. The time can vary depending on the size of the uterus, and the need to take down scarring from previous surgeries, and if other tissue, such as endometrial tissue, and other organs are being removed with your uterus (like your fallopian tubes or ovaries).

Long-term problems

in some cases hormone imbalance may happen after removal of ovaries
in some rare cases developing a prolapse or uncontrollable urge to pass urine may occur

How soon will I recover?

You will be able to go home when your gynaecologist decides you are medically fit enough, which is usually the same day or after 1 to 2 days.

Rest for 2 weeks and continue to do the exercises that you were shown in hospital.

You can return to work once your doctor has said you are well enough to do so (usually after 4 to 6 weeks, depending on your type of work). You should be feeling more or less back to normal after 2 to 3 months.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most women make a good recovery and return to normal activities.

Common instructions after hysterectomy are:

You can experience light vaginal bleeding for one to six weeks. Use only a light pantyliner or sanitary pad to catch the discharge.
Do not lift heavy objects (over 10 pounds) for at least four to six weeks.
Do not put anything into the vagina for four to six weeks, or as directed by your healthcare provider.
Do not have sex for six weeks after surgery.
You may take a shower. Wash the incision with soap and water (the stitches do not have to be removed, as they will dissolve in about six weeks). A bandage over the incision is not necessary. If surgical strips were used, they should fall off on their own within a week. If staples were used, they will need to be removed by your healthcare provider.
You can drive about two weeks after abdominal surgery or when you are no longer taking narcotics for pain. If you had a vaginal or laparoscopic hysterectomy, you might begin driving with a few days.
Resume your exercise routine in four to six weeks, depending on how you feel.
You can usually go back to work in three to six weeks, depending on what kind of work you do.

Summary

A hysterectomy is a major operation usually recommended after simpler treatments have failed. Your symptoms should improve.

For any further details please get in touch with your health provider or if you are in Gurgaon you can get in touch with Dr. Mamta Pattnayak (Gynae and Obstetrician in Fortis Hospital, Gurgaon)

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