Laparoscopic Supracervical Hysterectomy
The benefits of a laparoscopic, or minimally invasive, hysterectomy.
Hysterectomy is a surgical procedure to remove the uterus. It is most often performed for uterine fibroids (non-cancerous tumors), endometriosis (cells from the lining of the uterus growing on other organs), or uterine prolapse (falling of the uterus into the vagina).
Hysterectomy is the second most common surgical procedure performed on reproductive age women in the U.S. In recent years, there has been concern that hysterectomies were being performed more often than needed. We share this concern, and prefer to use non-surgical methods for managing most pelvic disorders. However, for some women, a hysterectomy is needed.
Nearly two thirds of all hysterectomies in the U.S. are still performed using the traditional method known as “total abdominal hysterectomy.” This procedure entails making a 6 to 10 inch skin incision on the belly and cutting through and separating the layers of the abdomen to remove the uterus. Total abdominal hysterectomy usually requires a two or three day hospital stay and four to six weeks of recovery.
While on faculty at the University of Washington in Seattle and Emory University in Atlanta, Dr. Lepine obtained extensive experience in performing vaginal hysterectomy. With this approach, the uterus is removed through the vagina, avoiding an abdominal incision. Hospital stay is usually only one day and most patients recover in three to four weeks.
Through further experience at the Atlanta Minimally Invasive Surgery Center, Dr. Lepine expanded her surgical repertoire to include laparoscopic supracervical hysterectomy (LSH). This minimally invasive hysterectomy is our preferred approach. During a laparoscopic supracervical hysterectomy, a laparoscope (a slender tube with a camera at the end) is used to visualize the abdomen and pelvis. The uterus is separated and removed through two to three tiny skin incisions. Because the morcellator has been taken off the market, a small incision is then made to remove the uterus. With an LSH, the cervix is left in place. However, women can choose to have their tubes and ovaries left in place or removed, depending on their age, hormonal status, and personal preference.
Because LSH is a minimally invasive approach, it results in less blood loss and post-operative pain. It has better cosmetic results and a more rapid recovery rate than other methods of hysterectomy, particularly as compared with abdominal hysterectomy. Sexual activity after a laparoscopic supracervical hysterectomy can resume in two weeks. Most women also return to their usual activities —including work and sports— within just a few weeks. Following this minimally invasive hysterectomy, patients are generally discharged the day of surgery, but can choose to stay overnight in the hospital if desired.
Women who have a recent or current abnormal Pap test or who prefer to have their cervix removed can still have the benefits of laparoscopic surgery for their “total hysterectomy.” In this case the uterus is separated from the surrounding structures and removed through the vagina. Then the top of the vagina is closed with non-permanent sutures.