Total Laparoscopic Hysterectomy Surgery

Total Laparoscopic Hysterectomy Surgery in Jaipur


Total Laparoscopic Hysterectomy Surgery

The total laparoscopic hysterectomy (TLH) offers women an option that is far less invasive than other surgical approaches. The need for a hysterectomy is an important and difficult decision.

The surgical removal of the uterus can be lifesaving for those suffering from gynecological cancers or the severe pain and heavy bleeding due to fibroids or endometriosis.

Today, there are several surgical approaches that are far less invasive than a total abdominal hysterectomy, which is still widely performed. Using a laparoscope — a slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments — surgeons have the ability to see inside the abdomen and technical access to the uterus, ovaries and fallopian tubes without having to make a large incision.

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What is a Total Laparoscopic Hysterectomy?

It is a minimal access surgical procedure which facilitates the removal of non prolapsed uterus through vaginal route. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient’s abdomen. The main benefit of this sort of hysterectomy is that patient will not need to possess a large cut in your abdomen as well as your recovery is generally much faster.

Cervix of the patient, or the neck from the womb, is also removed during this operation by laparoscopic technique. Uterine artery, Uterosacral ligament, cardinal ligament or Mackenrodt’s ligament, all is dissected from above. Ovaries of patient might be removed based on wishes of gynecologists as well as patients condition.

Not every patient is suitable for this total laparoscopic hysterectomy. If it’s suitable for the patient, Gynaecologist will decide type of hysterectomy require for the patient.

There are currently three surgical approaches to hysterectomies. These include:

1. Open, traditional hysterectomy. This involves a six to eight inch incision made in the abdominal wall.

2. Vaginal Hysterectomy. This involves removing the uterus through the vagina. This approach is better than the open, traditional hysterectomy, but still does not allow the surgeon a full view of the surrounding organs, including the bladder& ureter.

3. Total Laparoscopic Hysterectomy. Using a laparoscope , a slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments , gynecologists have the ability to see inside the abdomen and technical access to the uterus, ovaries and fallopian tubes without having to make a large incision. The duration of total laparoscopic hysterectomy varied 40-80 minutes (average 60 minutes). With advanced laparoscopic skills, gynecological surgeons are able to perform TLH. The surgery is completed utilizing only four tiny abdominal incisions 5mm to1cm long. Even a very large uterus can be removed laparoscopically using this technique. It offers numerous potential benefits over traditional approaches, particularly when performing more challenging procedures like radical hysterectomy for gynecologic cancer.

3 primary reasons for hysterectomy include:

.Removal of fibroids, which are non-cancerous tumors

.Treatment of endometriosis, the growth of the uterine lining outside of the uterus
Resolve uncontrolled bleeding caused by adenomyosis, cancer or pelvic organ prolaspe

<h4. Less blood loss
.Fewer complications
.Less scarring
. Decreased risk of infection

Post surgically, patients have a much quicker recovery, usually going home the same day or stay one overnight in the hospital. Often, patients are able to return to their normal routine in one to two weeks. Patients report less pain, minimal post-surgical pain medication use, and a faster recovery time than women undergoing abdominal hysterectomies who usually require a four to five days hospitalization and lengthy recovery time of usually six to eight weeks.

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What goes on throughout the surgery?

Surgery will be performed under a general anaesthetic. Carbon dioxide gas is going to be accustomed to inflate the abdomen through an isufflator and also to create space for that surgeon to operate. The gynecologist will insert the laparoscope with the umbilicus so the team can easily see what they are doing. The gynecologist will also make three small cuts within the abdomen to insert other instruments that are required for total laparoscopic hysterectomy surgery. A uterine is used from the vagina to elevate the uterus so that surgeon can perform surgery without damaging the surrounding bowel. Sometime if the uterine manipulator is not possible to introduce than myoma screw is used to manipulate the uterus. In the video which is showing above uterine manipulator is not used and a myoma screw is used.

The gynecologist will have a really clear view of the inside of patient abdomen and may use the image on screen to free uterus from the tubes, ligaments and arteries on each side. A cut may also be made round the cervix and into the vagina make it possible for the uterus to be removed through the vagina. The cut is going to be closed with absorbable stitches or stapled or glue.

If the ovaries and tubes should be removed simultaneously they will also be freed and removed through the vagina or through one of the port. The pelvic cavity is going to be beaten up having a sterile solution. The CO2 gas will be removed as much as possible and also the wounds closed with sutures.

Sometimes, a little drain tube is inserted through among the wounds to empty some blood stained fluid and gas after the operation. This is removed the very next day if everything is found normal.

How much time the TLH take?

The operation will often take the time between one and two hours.

After the operation what patient feel?

Patient will wake up with a tube inside bladder urinary catheter, an IV drip will be given to replace lost fluids, a drain tube, as well as an oxygen mask is required sometime. Generally after 4 hours patient will be offered something to drink, and from next day patient can start eating.

Patient will probably be able to eat breakfast the very next day. Additionally, patient will be able to shower and also have the drip and catheter removed. Most patients are discharged around the second day.