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Last Updated on November 27, 2025 by Bilal Hasdemir
At Liv Hospital, we know how vital advanced and compassionate care is for women having hysterectomies. A laparoscopic hysterectomy operation is a less invasive method. It has many advantages over traditional surgery.
We aim to give our patients the safest and most effective treatments. Total laparoscopic hysterectomy removes the uterus through small cuts. This cuts down on recovery time and scarring.
Our skilled team is all about personalized care for each patient. We focus on patient-centered care. We want to make the lavh procedure steps as easy and stress-free as we can.
Total laparoscopic hysterectomy (TLH) is a surgery that removes the uterus through small incisions. It’s important to know the differences between TLH and other types like LAVH and TLHBso.
TLH, LAVH, and TLHBso differ in what they remove and how they do it. TLH removes the uterus through laparoscopy. LAVH uses both laparoscopy and a vaginal approach. TLHBso takes out the uterus, ovaries, and fallopian tubes.
| Procedure | Description |
|---|---|
| TLH | Total Laparoscopic Hysterectomy – removal of the uterus through laparoscopic ports. |
| LAVH | Laparoscopic-Assisted Vaginal Hysterectomy – a combination of laparoscopic and vaginal approaches. |
| TLHBso | Total Laparoscopic Hysterectomy with Bilateral Salpingo-Oophorectomy – removal of the uterus, ovaries, and fallopian tubes. |
The laparoscopic method is used for many reasons. It’s for benign uterine diseases, some cancers, and when vaginal surgery isn’t possible. WebMD says it leads to less blood loss and faster healing than open surgery.
Laparoscopic hysterectomy has many benefits. It causes less pain, shorter hospital stays, and quicker recovery. It also means less blood loss and better looks. Studies show it leads to fewer problems and faster healing than open surgery.
Laparoscopic hysterectomy needs careful planning for the best results. We think a detailed preparation is essential for a successful surgery.
Choosing the right patient is key for a successful laparoscopic hysterectomy. We check each patient to see if they’re a good fit. Things that might stop us include big tumors or large pelvic masses. Key factors to consider include:
Imaging and lab tests are vital before surgery. They help us understand the patient’s health and spot any risks. Common tests include:
Getting the bowels ready and fasting are important steps before surgery. We suggest a clear liquid diet and bowel prep to lower the risk of bowel injury. Specific instructions depend on the patient’s health and the surgeon’s approach.
We tell patients to stick to a strict fasting schedule to avoid anesthesia problems. Usually, they’re asked to fast for 8-12 hours before the surgery.
Before starting a laparoscopic hysterectomy, the first step is to prepare the patient. This involves administering anesthesia to ensure the patient is comfortable and pain-free during the procedure. The patient is then positioned on the operating table in a way that allows for easy access to the surgical area.
Once the patient is settled, the operating room is set up with all the necessary equipment. This includes the laparoscope, which is a thin tube with a camera and light on the end, and other surgical tools. The goal is to create a clear and stable environment for the surgeon to perform the operation.
By carefully preparing the patient and setting up the operating room, the stage is set for a successful laparoscopic hysterectomy. This initial step is critical to the success of the procedure and ensures the patient’s safety and comfort throughout the operation.
Creating pneumoperitoneum is key in laparoscopic hysterectomy. It lets surgeons see the pelvic organs clearly. This step involves putting in a primary trocar and making sure the pneumoperitoneum works well.
There are two main ways to make pneumoperitoneum: using the Veress needle or the open Hasson technique. The Veress needle technique uses a special needle through a small umbilical cut. The open Hasson technique makes a small cut to see the peritoneal cavity directly.
The umbilical incision is very important. It’s where the primary trocar goes in. The incision must be planned and done carefully to avoid problems. Surgeons might pick a vertical or horizontal cut, based on the patient and their own style.
Choosing between the Veress needle and the open Hasson technique depends on several things. These include the patient’s health, the surgeon’s skill, and the surgery’s needs. The Veress needle technique is liked for being less invasive. The open Hasson technique gives a more controlled way into the peritoneal cavity.
After the primary trocar is in, carbon dioxide gas is used to make pneumoperitoneum. The gas pressure is watched closely to keep the environment safe and good for surgery. Keeping the right pressure is key for seeing well and avoiding issues.
By managing pneumoperitoneum and primary port placement well, surgeons can do a safe and effective laparoscopic hysterectomy. This step is very important for a clear view and a successful surgery.
Secondary trocar placement is key in laparoscopic hysterectomy. It gives more access for tools and helps in removing the uterus. We plan the trocar placement carefully to get the best access and avoid problems.
Where we put accessory ports is very important for a successful hysterectomy. We place them on the sides of the rectus abdominis muscles to avoid blood vessel injuries. The exact spot depends on the patient and the surgeon’s choice, but usually, two to three ports are used.
We place these ports while watching on a screen to make sure they go in right. This way, we get the best view of the pelvic area. It helps us dissect and remove the uterus efficiently.
When placing secondary trocars, avoiding injuries is a big deal. We use special techniques like looking closely at the spot and using blunt-tipped trocars. This makes it less likely to hurt anything.
We also think about the patient’s body layout, like where big blood vessels are. This helps us avoid problems and make the surgery safe and successful.
After the secondary trocars are set up, we put in the laparoscopic tools. The tools we choose depend on what the surgery needs, like cutting or sewing.
We pick top-notch laparoscopic tools for better control and safety. Using these tools through the secondary trocars lets us do the hysterectomy with great precision. This ensures the best results for our patients.
As we move forward with the laparoscopic hysterectomy, a detailed pelvic cavity assessment is key. It helps us spot important structures and any possible issues.
We take a close look at the pelvic area to see the ureters, uterine blood vessels, and other important parts. The laparoscope gives us a clear view, helping us find any problems or adhesions.
It’s very important to correctly identify these structures to avoid problems and get good results. We carefully check the pelvic area, noting any unique anatomy or issues that might change our plan.
Finding where the ureters are and how they run is a big part of this step. We follow the ureters through the pelvic area, making sure we know how they relate to other structures.
This knowledge is critical to prevent damage to the ureters during surgery. By seeing where the ureters are and how they move, we can protect them and make sure the surgery goes well.
We also check the pelvic area for any disease or adhesions. This includes looking at the uterus, ovaries, and nearby tissues for any problems.
By carefully checking the pelvic area and finding any disease, we can plan the best treatment for the patient.
The laparoscopic hysterectomy operation technique involves several key steps. These steps require precision and skill. They are critical for the success of the procedure and to avoid complications.
The first step is dividing the round ligaments. We use advanced bipolar or ultrasonic energy devices for this. These tools allow for precise dissection and hemostasis.
Dividing the round ligament helps mobilize the uterus. It also makes it easier to access the broad ligament. Then, we open the broad ligament. This creates a window for us to find and dissect the uterine vasculature.
Using laparoscopic instruments, we handle tissues gently and dissect precisely. This is important for the success of the operation.
Creating the vesicouterine space is another key step. It involves carefully dissecting the bladder from the uterus. This creates a safe area for further surgery.
We use both blunt and sharp dissection techniques. This helps avoid injury to the bladder or surrounding structures. It’s a delicate process.
Managing the infundibulopelvic ligaments is a critical part of the operation. These ligaments contain the ovarian vessels. We desiccate and transect them using advanced energy devices.
Our goal is to achieve secure hemostasis. We also aim to minimize the risk of bleeding or injury to surrounding structures. We carefully identify the infundibulopelvic ligaments and assess their relationship to the ureter.
Then, we apply energy devices to desiccate and transect the ligaments. We take care to avoid thermal spread to adjacent tissues.
In the sixth step of the laparoscopic hysterectomy, we focus on the precise techniques for ligating the uterine arteries and managing the cardinal ligaments. This step is key for reducing bleeding and keeping the vaginal vault strong after surgery.
The process starts with skeletonizing the uterine vessels. This means carefully removing the tissues around the uterine arteries to find the best place for ligation. This careful approach helps make the ligation effective and safe, reducing the chance of complications.
After skeletonizing the uterine vessels, we seal and cut them. Advanced energy devices are used for this, giving precise control and keeping damage to nearby tissues low. The choice of device depends on the surgeon’s style and the patient’s anatomy.
The cardinal ligaments are key to supporting the vaginal vault. Securing these ligaments is vital to prevent prolapse and ensure the hysterectomy’s long-term success. We do this by identifying and ligating the cardinal ligaments, often using a mix of suturing and energy-based devices.
Managing the uterosacral ligaments is also important for vaginal vault support. By including these ligaments in the repair, we improve the vaginal support structures’ durability.
In summary, the sixth step of the laparoscopic hysterectomy is complex and requires great attention to detail. By mastering the techniques of uterine artery ligation and cardinal ligament management, surgeons can achieve a successful outcome for their patients.
The seventh step in the laparoscopic hysterectomy operation is called colpotomy. This step is key for separating the uterus from the vagina. It makes it safe to remove the uterus.
A circumferential colpotomy detaches the uterus from the vaginal cuff. We use laparoscopic tools for a precise incision around the cervix. This method aims to reduce bleeding and harm to nearby tissues.
After the colpotomy, the uterus is ready for removal. There are two main ways to remove it:
Morcellation is key for larger uteri. We consider several factors before using it, including:
By planning and executing the colpotomy and uterine extraction carefully, we ensure a safe and effective laparoscopic hysterectomy operation.
Securing the vaginal cuff is key to a successful laparoscopic hysterectomy. It helps avoid complications like bleeding or infection after surgery.
Closing the vaginal vault with laparoscopic suturing is a precise task. We use special tools to make sure the closure is tight and reliable.
Barbed sutures are popular for their ease and secure knots. They offer a continuous closure, reducing the chance of complications.
We check and clean the surgical area carefully to stop any bleeding. This is done to ensure the vaginal cuff and nearby tissues are dry.
Then, we clean the pelvic area thoroughly. This step helps prevent infection and aids in a quick recovery.
| Technique | Description | Advantages |
|---|---|---|
| Laparoscopic Suturing | Using advanced laparoscopic instruments to close the vaginal cuff. | Secure closure, minimizes post-operative complications. |
| Barbed Suture Material | Utilizing barbed sutures for continuous closure. | Ease of use, secure knot formation. |
| Final Inspection and Irrigation | Meticulous inspection and irrigation of the surgical site. | Ensures hemostasis, reduces infection risk. |
By taking these steps and using the right techniques and materials, we ensure our patients have a good outcome from laparoscopic hysterectomy.
The time after a laparoscopic hysterectomy is key for a safe recovery. We’re here to help you through it. Knowing what to expect can make a big difference in your recovery.
After surgery, you’ll go to the recovery room. Our team will watch your vital signs and manage pain. Managing pain well is very important during this time. We use medicines and other methods to keep you comfortable.
Most patients go home the same day or the next morning. It’s important to have someone with you for at least 24 hours after coming home.
Women usually get back to normal in 2-3 weeks after the surgery. But, everyone recovers at their own pace. Some might need more time.
Some worry about how laparoscopic hysterectomy affects their stomach. The surgery itself doesn’t directly harm the stomach. But, some women might notice changes in their digestion or feel some discomfort in their belly.
“Some patients may experience changes in bowel habits or mild discomfort in the abdominal area during the recovery period,” says -Dr. a leading gynecologist. “But, these symptoms are usually temporary and go away by themselves.”
It’s important to follow your doctor’s advice on what to do and not do after surgery. Usually, we tell patients to avoid heavy lifting, bending, or hard activities for 4-6 weeks. Also, don’t drive until you’re off narcotic pain meds and can drive safely.
By understanding the recovery process and following your doctor’s advice, you can avoid problems and have a smooth recovery after your laparoscopic hysterectomy.
For the best results in laparoscopic hysterectomy, you need the right mix of skills, careful patient choice, and good care after surgery. Research shows that this method leads to less blood loss and shorter stays in the hospital compared to open surgery. For example, a study found that total laparoscopic hysterectomy had a median blood loss of 200 mL. This is much less than the 300 mL seen in total abdominal hysterectomy (source).
Surgeons can reduce risks and enhance patient results by following the steps of laparoscopic hysterectomy and sticking to the best practices. It’s vital to have the right training and tools for this surgery. We stress the need for choosing patients wisely, performing surgery with precision, and providing thorough care after surgery to get the best outcomes.
TLH removes the uterus through small incisions. LAVH uses both laparoscopic and vaginal approaches.
Women usually get back to normal in 2-3 weeks after this surgery.
It’s used for benign uterine conditions, some cancers, and when a vaginal hysterectomy isn’t possible.
Planning includes choosing the right patient, imaging, lab tests, bowel prep, and fasting. These steps reduce risks.
Pneumoperitoneum is made using a Veress needle or the open Hasson technique. This creates a safe space in the abdomen.
Secondary trocars give more access for instruments. They help in dissecting and removing the uterus.
The vaginal cuff is closed with laparoscopic suturing. Barbed sutures are often used for secure knots.
Complications can include bleeding, infection, and injury to nearby organs. But these are rare with skilled surgeons.
Yes, it can be done for larger uteri or complex cases. It may need more expertise and techniques like morcellation.
A: It usually doesn’t affect the stomach or digestive system. But some patients might have temporary bowel changes or discomfort.
