Hysterectomy - Comparison of Hysterectomy Procedures
Laparoscopic supracervical hysterectomy (LSH)
Laparoscopic supracervical hysterectomy is done by inserting a laparoscope and surgical instruments through several small abdominal incisions. The uterus is removed in small pieces through one of the incisions and the cervix is left intact. This is also known as subtotal or partial hysterectomy. This type of procedure usually causes minimal blood loss and pain. The hospital stay is shorter than for total abdominal surgery. Most women can return to normal activity a week or two afterward. LSH can be done:
- To remove uterine fibroids of any size.
- To remove a uterus of any size.
LSH usually takes longer to do than abdominal or vaginal hysterectomy. LSH is not available in some areas.
Total laparoscopic hysterectomy (TLH)
The total laparoscopic hysterectomy is done by inserting a laparoscope and surgical instruments through several small incisions in the abdomen. The uterus and the cervix are removed in small pieces through one of the incisions. TLH can be done:
- To remove uterine fibroids that are small to moderate in size.
- When there is not a lot of scar tissue in the pelvic area.
- When there is not a worry about cancer in the ovaries.
TLH requires the surgeon to have special training. It usually takes longer to do than abdominal or vaginal hysterectomy. But recovery and hospital stay are shorter than for total abdominal hysterectomy. TLH is not available in many parts of the country.
There are a number of ways that laparoscopic hysterectomies are done. Sometimes a tool called a morcellator is used to remove the uterus in small pieces. This procedure is not done if there is a risk of uterine cancer because the tool could cause the cancer to spread to other parts of your body. Talk to your doctor about your risks with a laparoscopic procedure.
Some laparoscopic surgery is done using only one incision. This is called laparoendoscopic single-site surgery (LESS) or single-port surgery.
Some doctors offer robot-assisted surgery for hysterectomy. For this method, the surgeon controls robotic arms that hold the surgery scope and tools. Robotic surgery for hysterectomy may be an option for women who have certain conditions. But it usually costs more money, and studies have not shown that it is better than other hysterectomy procedures.2