TLH is a major surgical procedure which involves removing the uterus and cervix using keyhole surgery.
Ovaries and fallopian tubes may or may not be removed depending on the reason for surgery.
Ureteric injuries can be prevented by using the ureteric shent during the surgery. It is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney.
You should get total Laparoscopic Hysterectomy with Sacrocolpopexy that will prevent vault prolapse in the future.
The advantages of a laparoscopic supracervical hysterectomy are:
- Smaller incisions which allows for a quicker postoperative recovery.
- Shorter hospital stay.
- Preservation of the cervix.
- Fewer surgical complications.
| Laparoscopic Hysterectomy | Vaginal Hysterectomy |
| 1-2 night hospital stay. | 1 night hospital stay |
| Internal and external incision | Internal incision only |
| 4 small abdominal scar | No abdominal scar |
| More expensive | Less expensive |
| General anaesthesia | Regional anaesthesia |
| Highest complication rate | Lowest complication rate |
The disadvantages of a laparoscopic supracervical hysterectomy:
- The possibility of adhesions leading to chronic pelvic pain.
- No difference between preoperative and posthysterectomy sexual response, regardless of whether the cervix had been removed or not.
A woman may have a hysterectomy for following reasons:
- Uterine fibroids
- Uterine prolapse
- Cancer of the uterus, cervix, or ovaries
- Endometriosis
- Abnormal vaginal bleeding
- Chronic pelvic pain
- Adenomyosis
- In a supracervial or subtotal hysterectomy a surgeon removes only the upper part of the uterus, leaving behind cervix
- In a total hysterectomy removes the whole uterus and cervix.
- In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina.
- A blood transfusion may be done to give you donated blood through an IV.
- Clotting factors, platelets, and plasma may be given during a transfusion to help stop your bleeding.
- Antifibrinolytic medicines to stop your bleeding.
- Surgery may be done to fix the blood vessel.
Abdominal Hysterectomy is the open hysterectomy done for a lond time, In this a surgeon makes a 5- to 7-inch incision across the belly. The surgeon then removes the uterus through this incision.
There is 3-4 days stay in the hospital and scar is left behind after the healing of the incision?
If there is descent / prolapse of the uterus then vaginal hysterectomy is done. So there is no scar over the abdomen.
During Laparoscopic Hysterectomy if vault suspension is not done properly there is a chance that later vault can prolapse.
Other complications may be due to adhesion formation and ovarian failure.
Ureteric injury may result from suture ligation, crushing and loss of blood supply resulting in devascularisation of the ureter.
