Total Laparoscopic Hysterectomy

A total laparoscopic hysterectomy is a minimally invasive surgery to remove your uterus and cervix. This surgery is performed by making several small cuts (incisions) in your abdomen. It can also be done with a thin, lighted tube (laparoscope) inserted into 2 small incisions in the lower abdomen. Your fallopian tubes and ovaries can be removed (bilateral salpingo-oopherectomy) during this surgery as well. If a total laparoscopic hysterectomy is started and it is not safe to continue, the laparoscopic surgery will be converted to an open abdominal surgery.

You will not have menstrual periods or be able to get pregnant after having this surgery. If a bilateral salpingo-oopherectomy was performed before menopause, you will go through a sudden (abrupt) menopause. This can be helped with hormone medicines.

Benefits of minimally invasive surgery include:

  • Less pain.

  • Less risk of blood loss.

  • Less risk of infection.

  • Quicker return to normal activities.

  • Usually a 1 night stay in the hospital.

  • Overall patient satisfaction.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any history of abnormal Pap tests.

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Desire for future fertility.

  • Any infections or colds you may have developed.

  • Symptoms of irregular or heavy periods, weight loss, or urinary or bowel changes.

RISKS AND COMPLICATIONS

  • Bleeding.

  • Blood clots in the legs or lung.

  • Infection.

  • Injury to surrounding organs.

  • Problems with anesthesia.

  • Early menopause symptoms (hot flashes, night sweats, insomnia).

  • Risk of conversion to an open abdominal incision.

BEFORE THE PROCEDURE

  • Ask your caregiver about changing or stopping your regular medicines.

  • Do not take aspirin or blood thinners (anticoagulants) for 1 week before the surgery, or as told by your caregiver.

  • Do not eat or drink anything for 8 hours before the surgery, or as told by your caregiver.

  • Quit smoking if you smoke.

  • Arrange for a ride home after surgery and for someone to help you at home during recovery.

PROCEDURE

  • You will be given antibiotic medicine.

  • An intravenous (IV) line will be placed in your arm. You will be given medicine to make you sleep (general anesthetic).

  • A gas (carbon dioxide) will be used to inflate your abdomen. This will allow your surgeon to look inside your abdomen, perform your surgery, and treat any other problems found if necessary.

  • Three or four small incisions (often less than ½ inch) will be made in your abdomen. One of these incisions will be made in the area of your belly button (navel). The laparoscope will be inserted into the incision. Your surgeon will look through the laparoscope while doing your procedure.

  • Other surgical instruments will be inserted through the other incisions.

  • The uterus may be removed through the vagina or cut into small pieces and removed through the small incisions.

  • Your incisions will be closed.

AFTER THE PROCEDURE

  • The gas will be released from inside your abdomen.

  • You will be taken to the recovery area where a nurse will watch and check your progress. Once you are awake, stable, and taking fluids well, without other problems, you will return to your room or be allowed to go home.

  • There is usually minimal discomfort following the surgery because the incisions are so small.

  • You will be given pain medicine while you are in the hospital and for when you go home.

  • Try to have someone with you the first 3 to 5 days after you go home. 

  • Follow up with your surgeon in 2 to 4 weeks after surgery to evaluate your progress.