Laparoscopic (Keyhole) Hysterectomy

A laparoscopic hysterectomy involves surgically removing the uterus while using a laparoscope (small camera at the end of a tube) to guide the removal through the vagina.
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What is a Hysterectomy?

A hysterectomy is a surgical procedure that involves the removal of the uterus, resulting in the inability to conceive or carry a pregnancy. Additionally, if you haven't already reached menopause, you will no longer experience menstrual periods after the surgery.

Hysterectomies are frequently performed on women, particularly those in the age range of 40 to 50, as it is a common medical intervention.

What types of Hysterectomy are there?

  • Subtotal Hysterectomy: In this procedure, only the main body of the uterus is removed. The cervix and other reproductive organs are retained.
  • Total Hysterectomy: The most common type of hysterectomy, it involves the complete removal of the uterus and cervix.
  • Total Hysterectomy with Bilateral Salpingo-oophorectomy: This procedure entails the removal of the uterus, cervix, fallopian tubes, and ovaries.
  • Radical Hysterectomy: In a radical hysterectomy, the uterus, cervix, and surrounding reproductive structures are removed. This includes the ovaries, fallopian tubes, a portion of the vagina, fatty tissue, and lymph nodes.
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How is Laparoscopic Hysterectomy performed?

Laparoscopic hysterectomy is a minimally invasive surgical procedure that involves creating two or three small incisions in the abdomen. Through these incisions, a tube-like camera is inserted to provide the surgeon with a view of the uterus (womb). Special surgical instruments are utilized to carefully remove the uterus, and if needed, the fallopian tubes and ovaries. Compared to traditional abdominal hysterectomy, this technique is less invasive, resulting in smaller scars and a faster recovery period. Typically, a hospital stay of around 1 to 2 days is required following the procedure.

What risks and complications are there?

While laparoscopic hysterectomy is generally considered safe, like any surgical procedure, it carries potential risks and complications. These may include:
  • Heavy bleeding and the formation of blood clots.
  • Infection or unwanted allergic reactions to anesthesia.
  • Damage to structures in the pelvic region, such as the urinary tract, bladder, rectum, or other nearby organs, which may require surgical repair.
  • In very rare cases, there is a risk of mortality associated with the procedure.
Jason Yap - Consultant Gynaecologist
Consultant Gynaecologist, Gynaecological Oncologist & Lead Clinician for Vulval Disease
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What are the reasons for having a Hysterectomy?

A hysterectomy is typically recommended when other treatment options have proven ineffective. It is a significant surgical procedure that results in the loss of fertility for women. Some common reasons for considering a hysterectomy include:
  • Heavy Periods: This condition, often caused by the presence of fibroids, can lead to excessive menstrual bleeding.
  • Pelvic Pain: Persistent pelvic pain may be attributed to conditions such as fibroids, endometriosis, adenomyosis, or unresolved pelvic inflammatory disease (PID).
  • Vaginal (Uterine) Prolapse: When the uterus descends or protrudes into the vaginal canal, causing discomfort or other complications.
  • Uterine, Cervical, or Ovarian Cancer: In cases where cancer is detected in these reproductive organs, a hysterectomy may be recommended as part of the treatment plan.
  • Uterine Fibroids: Noncancerous growths that develop in the uterus and can lead to symptoms such as pelvic pressure, heavy menstrual bleeding, and pelvic pain.
It is essential to consult with a gynaecologist to discuss your specific circumstances and determine whether a hysterectomy is the most suitable course of action for your situation.
Pre/post procedure information

What can I expect before and after Hysterectomy?

The following tests may be required before a hysterectomy:
  • Endometrial Biopsy: This procedure involves sampling the tissue from the lining of the uterus to identify any abnormalities or signs of cancer.
  • Cervical Screening (Pap Test): This screening method is used to detect abnormalities, particularly cervical cancer, by collecting cells from the cervix for examination.
  • Pelvic Ultrasound: A non-invasive imaging technique used to visualize and evaluate the size and condition of uterine fibroids, ovarian cysts, or endometrial polyps.

How can I prepare for my surgery?

To ensure a successful surgery and promote a speedy recovery, it is important to focus on maintaining optimal health. Here are some steps you can take to prepare for your hysterectomy:
  1. Stop smoking: If you are a smoker, it is strongly advised to quit smoking before your surgery, as smoking can increase the risk of complications and slow down the healing process.
  2. Eat a healthy and balanced diet: Prioritize nutritious foods that support overall health and healing. Incorporate fruits, vegetables, lean proteins, and whole grains into your meals.
  3. Exercise regularly: Engage in regular physical activity to improve your overall fitness and strength. Consult with your healthcare provider to determine suitable exercises for you.
  4. Maintain a healthy weight or lose weight if needed: Achieving and maintaining a healthy weight can help reduce the risks associated with surgery and improve your recovery.
In addition, you may have a pre-assessment appointment a few days before the procedure. This can involve blood tests and a general health check-up. It is an opportunity to address any concerns or questions you may have about the surgery.

What should I expect after my hysterectomy procedure?

Following your hysterectomy, here are some things you can expect:
  1. Discharge from the hospital: Depending on the type of hysterectomy and your specific situation, you may be able to go home on the same day as your procedure. Before discharge, you may need to undergo blood tests, receive prescribed medications, and have a bowel movement.
  2. Recovery period: It is normal to feel more tired than usual after the surgery. Emotionally, a hysterectomy can be challenging in the beginning, and it may take time to adjust. Physical and emotional recovery can vary, but typically take around six weeks. It is important to rest during the initial days but gradually introduce light exercises and activities as advised by your healthcare provider.
  3. Post-surgical bleeding: You may experience bleeding for up to three weeks. It is recommended to use sanitary pads instead of tampons to reduce the risk of infection. Maintain good hygiene practices during this time.
  4. Bowel function: Your bowel movements may be affected temporarily, and certain pain medications can also impact your bowels. If you experience any issues, it is important to consult your doctor for further guidance or potential adjustments to your medication.
  5. Sexual activity: It is generally advised to refrain from sexual intercourse for six weeks following the procedure. This timeframe allows for proper healing and reduces the risk of complications.
Remember to follow the specific instructions provided by your healthcare team for your individual situation. If you have any concerns or questions during your recovery, do not hesitate to reach out to your doctor for further guidance and support.