Laparoscopic Hysterectomy

Hysterectomy is the procedure that removes the uterus, ovaries, fallopian tubes, and cervix. There are many ways to conduct this procedure, Laparoscopy is one of them. Laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. It is a safe & effective process. A tiny camera is inserted through the belly button which allows doctors to see a patient’s internal organs. This procedure takes place under anesthesia. In Some cases, a woman’s uterus is removed, but not the cervix, this procedure is laparoscopic supracervical hysterectomy.

Why is it performed?

Doctors perform laparoscopic surgery is suggested when the patient is suffering from any of the following conditions:-

• Chronic pelvic pain
• Endometriosis
• Pelvic inflammatory disease
• Infertility
li>Removal of fibroids, uterus, lymph nodes, and ovarian cysts li>Ectopic pregnancy

How is Laparoscopic hysterectomy performed?

• Preparation and positioning
• Insertion of a urine manipulator
• Abdomen entry and placement of trocar
• Hug the ovaries
• Mobilization of the bladder
• Secure the urine vessels
• The uterus and cervix is separated from the vaginal apex

Reasons for Hysterectomy

• Uterine Fibroids

Sometimes there is a noncancerous growth of fibroids in the uterus also. They can furthermore cause pain and heavy bleeding. If other measures fail then doctors will have no choice other than hysterectomy

• Cancer

Need for hysterectomy is when you have cancer of the following: Cervix,Ovary,Uterus,Endometrial. In case of precancerous conditions or to avoid cancer in the future, doctors also recommend surgery.

• Endometriosis

Endometriosis is caused when the tissues that line the uterus grows outside. It can cause irregular periods. Some extreme pain ultimately leading to infertility also happens. Before hysterectomy is performed in the case of endometriosis, medical procedures and hormone therapy are done.

• Adenomyosis

Adenomyosis is caused when the lining of the uterus starts growing into the muscle of the uterus. This leads to the thickening of the uterus wall. It causes heavy bleeding and pain. In the case of adenomyosis also, hormone therapy and medications are tried first.

• Infection

PID also is known as Pelvic Inflammatory Disease leads to severe pelvic pain. It is due to bacterial infection. If found at an early stage, it can get better with antibiotics. But once it spreads it can damage the uterus. Hence doctors suggest a hysterectomy if you have a severe pelvic inflammatory

Types of hysterectomy

• A radical hysterectomy
• A total hysterectomy
• Super cervical hysterectomy
• Hysterectomy with oophorectomy

what is Laparoscopic Myomectomy ?

Laparoscopic Myomectomy is a surgical procedure that involves the removal of fibroids without causing any damage to the uterus. It is also known as the Robotic Myomectomy in the medical word. When the fibroid starts to cause too much problem in daily life, the doctors may recommend this surgery. The symptoms which might lead to the surgery are Pelvic pain, Frequent urination, Irregular bleeding, Heavy periods. Laparoscopic Myomectomy helps to remove fibroids with small abdominal incisions. There are several forms of myomectomy techniques depending upon the location and size of the fibroids.

How do you prepare for surgery?

Mentally prepare yourself for a change. The surgery will definitely bring some changes to your body. Talk to your close ones or take help from professionals. Follow these below-mentioned guidelines before your surgery:-

• Avoid wearing jewelry
• Try to wear loose-fitting clothes.
• Doctors will restrict you to eat, drink ( not even water ), or smoke after midnight before the day of the surgery
• You must not wear nail polish before the surgery.
• Wear low-heeled shoes before the day of surgery, as you might feel drowsy because of anesthesia

What happens during the procedure?

There are various steps a surgeon follows during the laparoscopic myomectomy procedure. Your surgeon will make four small incisions of ½ inch long in your lower abdomen while you are under general anesthesia. The surgeon will be able to see inside your abdomen. It happens when your belly is full of carbon dioxide. A laparoscope, i.e., a thin tube of light, along with a camera on one end, will be placed in one of the incisions. From the other incisions, small instruments will be placed. In the case of robotic surgery, your surgeon will use a robotic arm to control the instruments. If your fibroids are small in size your surgeon may prefer to cut those fibroids into small pieces, and in case they are too large, a larger incision will be made in your abdomen to conduct an abdominal myomectomy. At the end of the surgery, all the instruments will be removed, the carbon dioxide gas will be released, and the incisions will be closed.

Types of myomectomy techniques

Hysteroscopic myomectomy

In the case of hysteroscopic myomectomy, surgeons use a narrow telescope to visualize the uterine cavity. The telescope is inserted into the vagina and then passed through the cervix enabling the surgeons to see the uterine cavity. This technique is used to remove small fibroids.

Laparoscopically-assisted myomectomy

This technique is used to remove the fibroids that extend into the uterine wall or the ones that are exposed outside the uterine cavity. A laparoscope is inserted into the abdomen along with other instruments.

Robotic-assisted laparoscopic myomectomy

This process is similar to laparoscopic myomectomy. The only additional point to know about this procedure is it uses robotics.

Open abdominal myomectomy

In this procedure, surgeons get direct access to the uterus through a vertical incision into the abdomen. The incision made in this procedure is the largest incision made as compared to other techniques. It also needs more time to heal. When fibroids are too large, surgeons prefer this procedure.