Laparoscopic removal of the uterus
What is a hysterectomy?
A hysterectomy is surgery to remove the uterus and cervix. It is a minimally invasive procedure involving only a few small incisions in the lower abdomen. This procedure allows for the removal of the uterus and cervix. In certain cases, the ovaries and fallopian tubes may also be removed. These procedures are called oophorectomy and salpingectomy, respectively, and can be performed simultaneously with the hysterectomy.
When is this surgery necessary?
- Abnormal or heavy vaginal bleeding.
- Severe and chronic pelvic pain.
- Uterine fibroids.
- Uterine, cervical, or ovarian cancer.
- Uterine prolapse.
- Advanced stage endometriosis.
- Atypical endometrial hyperplasia.
You may also need a salpingectomy or oophorectomy if you are at high risk for ovarian cancer, certain types of breast cancer, or if you have ovarian or fallopian tube cysts.
What happens during the surgery?
Before surgery, you will be given anesthesia to sleep. A laparoscope—a thin tube with a camera at the end—is inserted into the abdominal cavity, usually near the navel through a small incision. Additional incisions will be made on the abdomen. Air will be used in the abdominal cavity to create more space between the abdominal wall and internal organs. The surgery will be performed using specialized instruments.
What preparation is needed for the surgery, and what tests should be done?
A number of tests are required, including:
- Complete blood count with leukocyte formula
- Biochemical blood test
- Rh factor and blood type
- Coagulogram
- Blood glucose
- General urinalysis
- Consultation with a therapist + ECG, dentist consultation (to exclude any loose teeth)
- Chest X-ray (if the previous one was done a year ago)
- Consultation with relevant specialists if there are chronic diseases (e.g., endocrinologist for diabetes, pulmonologist for asthma, etc.)
All these tests can be done at our clinic. There are no food or fluid restrictions the day before surgery. After midnight on the evening before surgery, abstain from food and drink. Bowel preparation, such as cleansing with an enema or special medications, is not required. We will also discuss all questions about whether to stop or continue taking medications before surgery.
Hospital stay duration - 2-3 days
How is the postoperative period?
On the day after surgery, you need to get out of bed, light physical exercises are allowed, and you may take liquid food. The day after surgery, you may eat any food, bandaging is performed in the hospital, and in most cases, discharge home occurs. At home, you should follow physical activity restrictions (lifting up to 5 kg is allowed in the first month). You can take a shower, but do not rub the incisions. If you have mild pain, oral painkillers are sufficient. The stitches on the abdomen need to be removed 12-14 days after the surgery. Sexual activity can be resumed when you feel comfortable. Your shoulders and back may hurt due to the gas used in the abdomen during surgery. Typically, these pains subside within three days. You may have some vaginal spotting after surgery, which usually resolves within 3-4 weeks. Use pads for spotting rather than tampons.
The incisions on the abdomen will be closed with special dissolvable sutures. Dressings are applied during the entire hospital stay, and after discharge, no further dressings are needed. The stitches need to be removed 12-14 days after the procedure. You can take a shower the next day after surgery, but do not rub the incisions.
In the first week after surgery, you may feel more tired than usual. Gradually increase your activity level through short walks and light activities.
How is the uterus removed during laparoscopy?
The uterus is usually removed through the vagina, similar to childbirth. In some cases, we remove it through the central trocar (located near the navel).
How long does laparoscopic hysterectomy take?
A laparoscopic hysterectomy usually takes between one and four hours, depending on the complexity of the case.
We will discuss all questions regarding the surgery and the postoperative period during our meeting at the clinic.
You can view these and other surgeries on my YouTube channel.
