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Post Hysterectomy

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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