Gynecologic surgeons were pioneers in developing laparoscopic surgery – a minimally invasive technique that uses an electronic device called a laparoscope to allow surgeons to see inside the patient's abdomen and perform procedures without making large incisions. Laparoscopic techniques can be used in correcting incontinence and prolapse and in performing procedures such as hysterectomy.
A hysterectomy is the surgical removal of the uterus and sometimes the ovaries and fallopian tubes as well. This is the second most common procedure for women in the United States. A hysterectomy stops the menstrual cycle and prevents pregnancy. It is a permanent procedure that cannot be reversed.
A traditional hysterectomy may be performed through incisions in either the abdomen or vagina. Newer technology is now available that allows for a simpler and less invasive procedure leaving the patient with less pain and shorter recovery time.
A laparoscopic supracervical hysterectomy, or LSH, involves making tiny incisions in the abdomen. The doctor inserts a laparoscope, a thin lighted telescope, and other surgical instruments through these incisions to carefully separate and then remove the uterus. Unlike other hysterectomies, LSH leaves the cervix intact. This can reduce the risk of later complications such as pelvic floor prolapse and urinary incontinence.
Candidates For Laparoscopic Supracervical Hysterectomy
The procedure is most often performed for those patients with abnormal uterine bleeding or fibroids. This procedure should not be performed on patients with a history of cervical dysplasia or endometriosis near the cervix. The doctor will determine eligibility for this procedure after a thorough evaluation of the uterus.
Benefits Of Laparoscopic Supracervical Hysterectomy
The laparoscopic supracervical hysterectomy offers patients benefits as a result of the minimally invasive technique. These benefits include:
- Smaller incisions
- A shorter hospital stay
- Reduced recovery period
- Reduced risk of complications
There are benefits to leaving the cervix intact. The cervix helps to maintain pelvic floor support. By retaining the cervix, the risk of pelvic floor prolapse, in which the pelvic organs move out of their normal position, is reduced. While some women may experience periodic bleeding by keeping the cervix intact, the benefits often outweigh this minor frustration.
It is important for women who undergo this procedure to continue to have annual Pap smears to screen for cervical cancer.
Laparoscopic Supracervical Hysterectomy Procedure
During a laparoscopic supracervical hysterectomy, your doctor will create four small incisions across the abdomen, into which the laparoscope and tiny surgical instruments are inserted. Carbon dioxide is administered into the abdomen allowing the surgeon more room to operate and reduce risks of damaging surrounding organs.
The surgical instruments are used to remove the uterus and the fallopian tubes and ovaries in some cases. This procedure can be performed using robotic technology, which allows for greater precision and more accurate results with less damage to surrounding tissue. The surgical instruments are inserted, with robotic arms that are controlled by your doctor, while the inside of your abdomen is viewed on a monitor.
Once the uterus is removed, the incisions are closed with no need for stitches because of their small size. This procedure is performed under general anesthesia in a hospital or outpatient surgical center.
After a laparoscopic supracervical hysterectomy, patients can return home either the same day or after an overnight hospital stay. Most patients can resume their normal activities within a week, although physical activity should be avoided for longer. Recovery is much faster and less painful than after a traditional hysterectomy. The patient will be provided with specific postoperative instructions to ensure a healthy and full recovery.
Surgical Risks And Complications
While a laparoscopic supracervical hysterectomy is considered a safe procedure for many patients, there are certain risks associated with any type of surgery. Some of these risks may include the following:
- Reactions to anesthesia
- Damage to the surrounding organs
The laparoscopic supracervical hysterectomy can relieve symptoms of abnormal bleeding, fibroids and other painful conditions but is a procedure for patients who meet the criteria for the procedure.