Last Updated on November 27, 2025 by Bilal Hasdemir

At Liv Hospital, we know how important clear guidance is for complex medical procedures like laparoscopic hysterectomy. This surgical technique has changed how we treat many gynecological issues. It offers a safer and less painful option compared to traditional surgery.

Going through surgery can be scary. Our team is here to offer compassionate care and personalized support every step of the way. Knowing what happens during a laparoscopic hysterectomy helps patients get ready for the surgery and recovery.

Key Takeaways

• Laparoscopic hysterectomy is a minimally invasive surgical procedure.
• It offers a safer and less painful alternative to traditional surgery.
• Personalized care and support are provided throughout the treatment process.
• Understanding the procedure can help patients prepare for recovery.
• Liv Hospital is committed to internationally recognized protocols and quality care.

Understanding Lap Hysterectomy

Laparoscopic hysterectomy is a new way to do hysterectomies. It removes the uterus through small cuts in the belly. A laparoscope helps doctors see inside.

Definition and Types

This surgery comes in different types. They vary based on how much is done and the method used. The main types are total laparoscopic hysterectomy (TLH) and laparoscopic-assisted vaginal hysterectomy (LAVH).

• Total Laparoscopic Hysterectomy (TLH): The whole surgery is done through small cuts.
• Laparoscopic-Assisted Vaginal Hysterectomy (LAVH): It mixes laparoscopic and vaginal methods.

Benefits

Laparoscopic hysterectomy has many advantages. It leads to less pain and quicker healing than open surgery.

Choosing this surgery means faster recovery and less scarring. It also lowers the chance of problems. Doctors look at each patient’s needs to pick the best surgery.

Patient Selection and Preparation

Choosing the right patients for laparoscopic hysterectomy is key for success. This surgery needs careful thought about the patient’s health and specific needs.

Ideal Candidates for Laparoscopic Hysterectomy

Those with benign uterine issues, like fibroids or endometriosis, are often good candidates. We look at each patient’s medical history, current health, and past surgeries.

Deciding on laparoscopic hysterectomy depends on several things. These include the uterus’s size and location, adhesions, and the patient’s health. 

Preoperative Evaluation

A detailed preoperative check is vital to see if a patient is right for laparoscopic hysterectomy. This includes a full medical history, physical exam, and tests like ultrasound or MRI.

We also check the patient’s overall health, including any health issues that might affect surgery or recovery. This careful evaluation helps reduce risks and improve results.

Equipment and Operating Room Setup

The success of a laparoscopic hysterectomy depends on the right equipment and a well-set operating room. The right setup helps the surgeon perform the procedure better and keeps the patient safe.

Essential Equipment for Laparoscopic Hysterectomy

Laparoscopic hysterectomy needs special equipment to work well. The key tools include:

• Laparoscopic instruments (e.g., graspers, dissectors, scissors)
• A high-definition camera system for clear vision
• A light source to light up the area
• A uterine manipulator to help with the procedure
• An electrosurgical unit for cutting and coagulation

These tools are vital for the precision needed in laparoscopic surgery. The laparoscopic equipment must be in top shape and ready to use.

Operating Room Configuration

The setup of the operating room is just as important as the equipment. A well-thought-out layout helps the surgical team work better together. Important factors include:

By planning the operating room setup carefully, we can avoid problems and make the hysterectomy surgery smoother.

Anesthesia and Patient Positioning

Effective anesthesia and proper patient positioning are key for a successful laparoscopic hysterectomy. We will explore these elements to ensure a smooth and safe procedure.

Anesthetic Considerations

General anesthesia is usually used for this surgery. The anesthesiologist must consider the patient’s health, risks, and pain management needs.

The choice of anesthetic agents and techniques is important. Using a mix of agents can reduce side effects and speed up recovery.

Patient Positioning Techniques

Proper patient positioning is vital for access to the pelvic organs. The lithotomy position is often used for this reason.

To keep the patient safe and comfortable, careful attention is needed. This includes securing the patient and padding areas at risk of pressure.

Initial Steps of Laparoscopic Hysterectomy

Starting a laparoscopic hysterectomy is key to success. We make the abdominal cavity safe for surgery.

Creating pneumoperitoneum is a big step. We fill the belly with carbon dioxide gas.

Creating Pneumoperitoneum

We manage the gas pressure carefully. It’s usually between 12-15 mmHg. This helps us see clearly and avoid problems.

Trocar Placement

After setting up the gas, we put in trocars. These are special ports for our tools.

Where we place the trocars is very important. We use them to see and move around inside. We often use ones near the belly button and on the sides.

These first steps are vital for a good laparoscopic hysterectomy. They help make the surgery safe and effective for our patients.

Dissection and Identification of Structures

During a laparoscopic hysterectomy, it’s important to carefully dissect and identify key structures. This step is key to the surgery’s success and helps avoid complications.

Dissection Techniques

Choosing the right dissection techniques is critical in laparoscopic hysterectomy. We use both blunt and sharp dissection, depending on the area and tissue type.

For example, sharp dissection is best for cutting the round ligaments. Blunt dissection works well for the vesicouterine space. The technique used varies based on the surgeon’s style and the case’s needs.

Identification of Uterine and Adnexal Structures

It’s vital to accurately identify uterine and adnexal structures. This includes finding the ureters, uterine arteries, and utero-ovarian ligaments. We must dissect these areas carefully to prevent injury.

• Keeping a clear view of the area
• Avoiding damage to nearby structures
• Ensuring no bleeding to prevent complications

In summary, dissection and identifying structures in laparoscopic hysterectomy need precision and knowledge of pelvic anatomy. By using careful dissection and identifying key structures, we can make the procedure safe and successful.

Step-by-Step Guide to Laparoscopic Hysterectomy

We will walk you through the laparoscopic hysterectomy process. This method is less invasive and offers many benefits. Our guide aims to give you a full understanding of what happens during the surgery.

Division of the Round Ligaments

The first step is to divide the round ligaments. This is a key part of the surgery that needs to be done carefully. Advanced tools are used to cut the ligaments, making it easier to reach the uterus.

Dissection of the Vesicouterine Space

After the round ligaments are cut, we move on to the vesicouterine space. This is where we carefully separate the bladder from the uterus. It’s a delicate task that requires special tools for precision.

Ligation of the Uterine Vessels

Ligation of the uterine vessels is a critical step. We identify, tie, and then cut the vessels to stop bleeding. This step is done with great care to avoid too much blood loss.

Removal of the Uterus

The last step is removing the uterus. After the vessels are tied and the area is prepared, the uterus is taken out. It can be removed through the vagina or a small cut in the abdomen, depending on the situation.

Our team focuses on each step with the utmost care and precision. We always put the patient’s safety and comfort first.

Trocar Insertion

Getting the trocar in right is key for laparoscopic hysterectomy success. It needs careful planning and doing to safely get into the belly.

We start by picking the best spot for the umbilical trocar. This spot is near the belly button because it’s less blood and easy to get to. It’s great for putting in the laparoscope, giving a clear view inside.

Here are the main steps for trocar insertion:

1. Make a small cut at the chosen spot, often the belly button.
2. Put in the Veress needle or use the Hasson technique for safe entry.
3. Check it’s in the right place with aspiration or other methods.
4. Put the trocar through the cut, making sure it’s secure and right.

Medical guidelines show that putting trocars in correctly is very important. It helps avoid problems and makes the surgery a success.

“The safety of laparoscopic entry is key, and the technique choice should match the surgeon’s skill and the patient’s body.”

By sticking to the right steps and using the best methods, doctors can safely insert trocars. This sets up a good start for a successful laparoscopic hysterectomy.

Creating Pneumoperitoneum

We make pneumoperitoneum by filling the belly with carbon dioxide (CO2) gas. This is key in laparoscopic hysterectomy. It gives the surgeon a clear view of the area.

To start, we use a Veress needle or direct trocar insertion. The Veress needle has a special spring-loaded tip. It helps safely enter the belly.

Next, we add CO2 gas to the belly. We increase the pressure slowly, aiming for 15-20 mmHg. This lifts the belly wall off the organs, making room to work.

Important considerations include watching the CO2 pressure. We also check the needle or trocar’s placement. Keeping the pressure stable is critical during the surgery.

Dissection and Hemostasis

Effective dissection and hemostasis are key in laparoscopic hysterectomy. We use precise dissection techniques to find and keep vital structures safe. This helps avoid complications.

We also use advanced hemostasis techniques to stop bleeding. This reduces the need for blood transfusions and helps in a quicker recovery. By combining careful dissection with effective bleeding control, we ensure a successful outcome.

References

1. 1. American College of Obstetricians and Gynecologists. (n.d.). Total laparoscopic hysterectomy – Module S COG017. Retrieved from https://www.acog.org/education-and-events/simulations/scog017/module

1. MedlinePlus. (2025, February 3). Hysterectomy – laparoscopic – discharge. Retrieved from https://medlineplus.gov/ency/patientinstructions/000276.htm
2. Chiofalo, B., Valenti, G., Madeo, D., Vizza, E., & Ciancio, F. (2023). A step-by-step decalogue for performing a simplified type A total laparoscopic hysterectomy using fewer accesses and tools. Gynecology and Pelvic Medicine, 6, Article 9643. https://doi.org/10.21037/gpm-23-26