Laparoscopic
Hysterectomy: How It Is Performed
When you are scheduled for a hysterectomy, you'll be
asked what kind of hysterectomy procedure you'd like
to undergo. There are three surgical procedures that
are possibilities. They are:
- Abdominal hysterectomy
- Laparoscopic hysterectomy
- Vaginal hysterectomy
If you choose to have your doctor perform a laparoscopic
hysterectomy, there are things that you need to be aware
of including how it is performed and the risks that
are involved.
First, you should know what it means to have a laparoscopic
hysterectomy. To begin, your doctor will create many
incisions in your abdomen and a laparoscope will be
placed into your belly button. Your uterus will be removed
one of two ways:
- Ground up and removed through the incisions
- Intact through your vagina.
You can also have a laparoscopic assisted vaginal hysterectomy,
laparoscopic supracervical hysterectomy and laparoscopic
total hysterectomy performed on you. Each one is different
and should be considered carefully.
A Brief Overview of the Laparoscopic Varieties
Laparoscopic Assisted Vaginal Hysterectomy –
This is a new procedure, which can give women with adhesions
another surgical option such as vaginal hysterectomy.
However, this procedure does not address the problem
of a uterus that's too big or the cervix being removed.
Laparoscopic Supracervical Hysterectomy – When
this procedure is performed, a woman has three small
incisions made: one near her belly button and two others
near her hipbones. Her uterus will be cut off from the
blood supply and cervix. It's then cut into strips and
pulled through a tube.
Laparoscopic Total Hysterectomy – this procedure
is similar to the Laparoscopic supracervical hysterectomy.
However, this procedure removes the cervix and uterus,
possibly through the vagina.
A Look At Laparoscopic Supracervical Hysterectomy
and How It Is Performed
How will the surgeon perform this type of hysterectomy?
The woman will be put asleep and a retractor will be
placed in her vagina so that it reaches her cervix.
This retractor will move the uterus around so that the
surgeon can see other areas of the organ.
Afterward, the surgeon will make a series of small
incisions at the belly button base and two other incisions
near the hipbones. He/she will use carbon dioxide gas
to fill up the abdomen to make sure that non of the
organs in the area are injured accidentally by the medical
instruments being used.
The doctor will insert the laparoscope through the
incision near the belly button. Instruments that are
used to grasp and pull are placed into a second incision.
The retractor that's going to be held by the surgeon
assistant will utilize the third incision.
Both the uterus and ovaries will be released from the
body's blood supply and cervix. Permanent ligament sutures
will hold up the cervix and it will be coagulated to
prevent any monthly bleeding cycle. Peritoneum is a
thin layer that covers the cervix and other things in
the abdomen.
The doctor will then use the morcellator (tube with
round blade at one end) and will make cuts into the
reproductive organs that are to be removed so that they
will be removed in strips. These strips will be sent
to the pathology lab to test for diseases.
The abdomen will be checked carefully for bleeding,
instruments will be removed from the incisions and the
gas used to fill up the abdomen will be emptied. Incisions
will be closed using sutures.
A Look At Laparoscopic Total Hysterectomy
When a doctor performs a laparoscopic total hysterectomy,
the uterus and cervix are removed intact unless the
uterus is too big. The difference between the laparoscopic
total hysterectomy and laparoscopic supracervical hysterectomy
is that the uterus and cervix will be removed by way
of the vagina. Openings in the vaginal cavity will be
sutured closed.
If a uterus is too big to be removed whole, it will
be lacerated into small pieces and removed through the
vagina with the same laparoscopic supracervical hysterectomy
procedure.
Recovery procedures are for both surgeries are identical
but after the total hysterectomy, there is no need for
pap smears unless the surgery was for cervical cancer.
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