Laparoscopic Hysterectomy: What Is It?
Abdominal and vaginal hysterectomy are two options
for women facing removal of the uterus. A third option
is the laparoscopic hysterectomy. In this surgery, the
first incision is made just below the navel. A thin
tube with a tiny camera is inserted into to incision
allowing the surgeon to view the abdominal cavity.
Once the doctor has viewed the reproductive organs,
he will make additional incisions, usually about one
inch long. Through theses incisions he will place tiny
instruments to detach the uterus from its supporting
structures and cut it into small pieces which can be
removed through the incisions. Following completion
of the surgery the incisions are sutured.
The laparoscope, or small camera may be used to assist
in vaginal hysterectomies. The disadvantage of a vaginal
hysterectomy is that the doctor has no direct view of
the abdominal cavity. By inserting a laparoscope in
a small incision below the navel, the surgeon has a
clear view of the uterus and surrounding organs, and
can still complete a vaginal procedure.
Another type of laparoscopic hysterectomy is the supracervical
hysterectomy. In this surgery the uterus is removed,
but the cervix is left intact. The advantages of leaving
the cervix intact where medically possible is that there
is less chance of sexual dysfunction and the cervix
helps provide support for surrounding organs.
The recovery time for laparoscopic hysterectomy is
shorter than that for a traditional abdominal hysterectomy.
Because laparoscopic surgery is less invasive, the risk
of post surgical complications, like infection, is reduced.
It is typically performed under general anesthesia and
there is always the risk of adverse reaction to anesthesia.
Not every patient is a candidate for laparoscopic hysterectomy.
It is effective for women with small to medium fibroids
and mild to moderate endometriosis. The patient and
surgeon must decide if this is the right procedure,
or if a laparoscopic assisted vaginal hysterectomy or
an abdominal hysterectomy may be more appropriate treatment.
Hysterectomies are only performed in women under thirty
five in cases where there are no other medical options.
Women who have a hysterectomy can no longer have children.
There have been other reported side effects of hysterectomy
including sexual dysfunction. Women should discuss their
concerns with their doctor and possibly get a second
opinion from another qualified doctor before undergoing
surgery.
The most common conditions requiring hysterectomy are
benign fibroid tumors, endometriosis, and uterine cancer.
While there are other medical treatments for endometriosis
and fibroid tumors, in most cases, hysterectomy is the
best option for treatment of uterine malignancy.
As medical science progresses doctors have come to
agreed, the less invasive surgery is , the better the
outcome is likely to be. For this reason, more doctors
are turning to vaginal and laparoscopic procedures whenever
possible. Women prefer less invasive surgeries, because
they leave little to no scarring. Older patients tend
to withstand less invasive procedures better. There
are fewer post surgical complications and a shorter
recovery period.
A woman facing a hysterectomy should discuss her surgical
options with her doctor. It may not be possible or appropriate
for all patients to have vaginal or laparoscopic hysterectomies.
If you doctor feels you should have a traditional abdominal
hysterectomy, find out his reasons. If you have any
doubts, always seek a second opinion.
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