Hysterectomy, surgical removal of the uterus, is one of the most commonly performed gynecologic surgeries Total laparoscopic hysterectomy is a keyhole or minimally invasive surgery performed through very small incisions in the abdomen using specialized instruments.
How is Hysterectomy performed?
Firstly through a tiny incision, a camera is inserted. The surgeon sees the entire procedure on the TV monitor placed in front of him. Then, a few more incisions are made and through these, specialized instruments are inserted and used for the uterus removal process. The reasons for hysterectomy vary from endometriosis and fibroids to cancer. Traditionally, all gynaec surgeries were done by keeping a 6-8 inches incision in the abdominal wall. Nowadays the laparoscopic hysterectomy is considered to be the gold standard method for gynecological issues. The faster recovery time, relatively small amount of postoperative pain, short convalescent period and hence hospitalization, better cosmetic results, ability to resume normal activities in a shorter time after the operation are some of the advantages which make laparoscopy very popular among patients and gynecologists.
However, there are some clinical conditions which can pose limits and can turn laparoscopic hysterectomy in a very challenging procedure. These conditions are
The presence of large uterus or large cervical fibroid
The presence of adhesions due to previous cesarean sections or previous pelvic surgeries (removal of fibroids or appendix)
Presence of pelvic varicosities
The presence of other pathologies like endometriosis(chocolate cyst) or large ovarian cyst
But laparoscopic hysterectomy can be successfully performed in these patients by an experienced gynecologist with minimal morbidity.
Laparoscopic Surgery: The best way to perform Hysterectomy
In the past 20-30 years, advanced operative laparoscopy procedures, including laparoscopic hysterectomy, have been developed and improved substantially. The magnification offered by laparoscope helps the gynecologist in viewing each and every structure minutely and identify the right surgical planes. Even patients with previous abdominal and pelvic surgeries are no longer contraindications of total laparoscopic hysterectomy and the surgical success rate is 100%. However, the procedure should be performed by a gynaecologist with experienced laparoscopic skills.