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General News Total Laparoscopic Hysterectomy Hysterectomy has been for many years a highly successful form of therapy for certain women's pelvic diseases. Although it has been the subject of much debate in recent years due to its overuse in some cases, it still remains a very important therapeutic alternative for many women whose pelvises have developed life threatening or life disturbing problems: cancer or pre-cancerous lesions, chronic pain, uncontrollable bleeding, endometriosis, fibroid tumors. A woman must decide for herself at what point in life, if ever, hysterectomy is right for her. But when she does decide for it, she wants the procedure to be as easy on her as possible and to interfere as little as possible with her life. In the mid 1980's, it became possible to use a laparoscope (band-aid surgery) to partially remove the uterus. The rest of the procedure was carried out through the vagina. Now it is possible to do the entire procedure using nothing more than the laparocopic procedure. The laparoscope used for Total Laparoscopic Hysterectomy (TLH) is a telescope, 1/2 inch in diameter inserted through the belly button under anesthesia. Other operating and grasping instruments are inserted through even smaller incisions in the lower abdomen. The telescopic picture is projected on a screen by means of a video camera. Thereby, the surgeon and assistant can see the pelvis and work together as an operative team. The procedure is so minimally invasive that often the patient can go home the next day and can resume 90% of normal activity within 1 1/2 to 2 weeks. This is truly revolutionary in light of the traditional three or four day hospital stay and six weeks convalescence so characteristic of the older standard abdominal techniques. In addition to the hysterectomy, if needed, one or both ovaries and tubes can be removed and the bladder or other pelvic structures can be repaired. If a woman has pelvic scarring (adhesions) or endometriosis, these can be eliminated at the time of the TLH through the laparoscope. |
