Laparoscopic Hysterectomy

A laparoscopic hysterectomy is a minimally invasive surgery to remove the uterus (womb) through small abdominal incisions. It uses a thin, lighted tube (laparoscope) and specialized tools. Depending on your condition, the procedure may also involve removing the cervix, ovaries, or fallopian tubes.

Types of hysterectomy:

• Total hysterectomy: Removal of the uterus and cervix.
• Subtotal hysterectomy: Removal of the uterus (cervix remains).
• With bilateral salpingo-oophorectomy: Removal of ovaries and fallopian tubes (if needed).

Why is it Performed?

Your gynaecologist may recommend this surgery for:

• Heavy/persistent menstrual bleeding.
• Uterine fibroids, endometriosis, or adenomyosis.
• Pelvic pain unresponsive to other treatments.
• Precancerous or cancerous conditions of the uterus, cervix, or ovaries.

Before Surgery

• Pre-operative consultation: Discuss risks, benefits, and alternatives (e.g., abdominal or vaginal hysterectomy).
• Tests: Blood tests, imaging (ultrasound/MRI), or cervical screening.
• Preparation:
  • Fasting: No food/drink for 6–12 hours before surgery.
  • Medications: Adjust or stop blood thinners (as advised by your doctor).
  • Bowel prep: Rarely required (only if bowel involvement is suspected).
• Arrange support: Someone must drive you home and assist for 1–2 days post-surgery.

During the Procedure

1. Anaesthesia: General anaesthesia (you’ll be asleep).
2. Incisions:
   1. 3–4 small cuts (0.5–1.5 cm) in the abdomen.
   1. Carbon dioxide gas inflates the abdomen for visibility.
3. Surgery:
   1. The uterus is detached from surrounding tissues and removed through the vagina or in small pieces via the laparoscope.
   1. Ovaries/tubes are removed if necessary.
4. Closure: Stitches or glue close the incisions.
5. Duration: 1–3 hours (varies with complexity).

Risks and Complications

• Common (temporary):
  • Shoulder/neck pain (from gas).
  • Mild bloating, bruising, or vaginal spotting.
• Rare but serious:
  • Infection, bleeding, or damage to nearby organs (bladder, bowel).
  • Blood clots (deep vein thrombosis).
  • Conversion to open surgery (larger incision) if complications arise.
  • Early menopause (if ovaries are removed).

Recovery

In the hospital:

• Most patients go home the same or next day.
• Pain relief and anti-nausea medications are provided.

At home:

• Rest: Avoid heavy lifting, exercise, or driving for 2–4 weeks.
• Pain management: Use prescribed medications or over-the-counter options (e.g., paracetamol).
• Wound care: Keep incisions clean/dry; watch for redness/swelling.
• Vaginal bleeding: Light spotting for 1–2 weeks is normal. Use sanitary pads (not tampons).
• Activity:
  • Walk gently to aid recovery and prevent blood clots.
  • Gradually resume daily tasks over 2–6 weeks.

Long-Term Effects

• Menopause: Occurs immediately if ovaries are removed.
• No periods: Permanent end to menstrual bleeding.
• Hormones: If ovaries remain, menopause will occur naturally.
• Sexual activity: Wait 6–8 weeks post-surgery; discuss concerns with your doctor.

Frequently Asked Questions

Q: Will I gain weight after surgery?
A: No direct link, but lifestyle changes during recovery may affect weight.

Q: Can the surgery affect my bladder/bowel?
A: Temporary bladder/bowel changes (e.g., urgency) are possible but usually resolve.

Q: Will I need HRT if my ovaries are removed?
A: Hormone replacement therapy (HRT) may be recommended to manage menopause symptoms.

Q: When can I have sex?
A: Wait until cleared by your doctor (usually 6–8 weeks).

eGynaecologist Advice:

• You should seek gynaecological help if you have severe pain, fever, or chills after laparoscopic procedure or notice heavy bleeding or foul-smelling discharge from incisions
• You must seek urgent gynaecological review if you develop chest pain, shortness of breath, or calf swelling after while you are recovering from laparoscopic hysterectomy
• This procedure stops menstruation and typicallytakes 2–6 weeks to return back to work, depending on job demands. You will not need to have cervical smears

Hysterectomy procedure stops menstrual periods permanently and if ovaries are removed, menopause begins immediately. You should consult your gynaecologist if you need hormone replacement after hysterectomy