This video demonstrates step by step total laparoscopic hysterectomy. Hysterectomy is the removal of the uterus with surgery. There are many reasons a hysterectomy can be performed such as fibroids, heavy or irregular menstrual bleeding, prolapse, chronic uterine pain, pelvic inflammatory disease, pre-cancerous conditions, cancer, and endometriosis. hysterectomy depending on the clinical circumstances. A hysterectomy can be performed using a laparoscope, which is a thin keyhole camera that allows the surgeon to see the pelvic organs. The laparoscope and other instruments are inserted through small incisions in the skin and then used by the surgeon to remove the uterus. hysterectomy depending on the clinical circumstances. A hysterectomy can be performed using a laparoscope, which is a thin keyhole camera that allows the surgeon to see the pelvic organs. The laparoscope and other instruments are inserted through small incisions in the skin and then used by the surgeon to remove the uterus.

A hysterectomy is a surgical procedure to remove a woman’s uterus. It is commonly performed to treat conditions such as uterine fibroids, heavy menstrual bleeding, endometriosis, pelvic pain, or certain cancers. Depending on the patient’s condition and the surgeon’s approach, hysterectomy can be performed through the abdomen, vagina, or using minimally invasive laparoscopic or robotic techniques. Understanding the basic steps of this surgery can help patients feel more informed and prepared.

1. Preoperative Preparation

Before the surgery, several preparations are made:

• Medical evaluation: Blood tests, imaging, and anesthesia assessment.

• Bowel preparation: In some cases, a bowel cleanse may be advised.

• Consent and counseling: The surgeon explains the procedure, risks, and recovery process.

2. Anesthesia

Hysterectomy is typically performed under general anesthesia, ensuring the patient is unconscious and pain-free throughout the procedure. In some cases, regional anesthesia like spinal or epidural anesthesia may be used.

3. Incision and Access

The approach depends on the type of hysterectomy:

• Abdominal Hysterectomy: A horizontal or vertical incision is made in the lower abdomen.

• Vaginal Hysterectomy: The uterus is accessed through the vagina, avoiding external incisions.

• Laparoscopic or Robotic Hysterectomy: Small keyhole incisions are made in the abdomen, and a camera with surgical instruments is inserted.

4. Detachment of Uterus

The uterus is carefully detached from its supporting structures:

• Ligaments: Uterosacral, round, and cardinal ligaments are cut and secured.

• Blood vessels: Uterine arteries are ligated to prevent bleeding.

• Fallopian tubes and ovaries: Depending on the procedure, these may also be removed or preserved.

5. Removal of Uterus

Once detached, the uterus is removed:

• In abdominal or vaginal hysterectomy, it is removed intact.

• In laparoscopic/robotic procedures, the uterus may be morcellated (cut into smaller pieces) to facilitate removal through small incisions.

6. Closing the Incision

After removal:

• The surgeon ensures hemostasis (stops any bleeding).

• Vaginal cuff or abdominal incision is closed with sutures.

• In laparoscopic surgery, the small incisions are closed with fine sutures or surgical glue.

7. Postoperative Care

After surgery:

• Patients are monitored in the recovery room until fully awake.

• Pain management and early mobilization are important to prevent complications.

• Patients are given instructions on wound care, activity limitations, and follow-up visits.

8. Recovery

• Recovery time varies depending on the surgical approach:

  • Vaginal and laparoscopic hysterectomies generally allow faster recovery.

  • Abdominal hysterectomy may require a longer hospital stay and recovery period.

• Normal activities can usually resume gradually within a few weeks, but heavy lifting should be avoided for several weeks.