58542 Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)

Name of the Procedure:

Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
Common name(s): Laparoscopic supracervical hysterectomy with salpingectomy and/or oophorectomy

Summary

This is a minimally invasive surgical procedure where surgeons remove the upper part of the uterus (leaving the cervix intact) and may also remove one or both fallopian tubes and/or ovaries, all through small incisions in the abdomen.

Purpose

The procedure addresses conditions such as fibroids, endometriosis, chronic pelvic pain, or abnormal uterine bleeding. The goals include alleviating symptoms, preventing disease progression, and improving the patient's quality of life.

Indications

• Uterine fibroids
• Endometriosis
• Chronic pelvic pain
• Abnormal uterine bleeding
• Ovarian cysts or tumors
• Risk of ovarian cancer

Preparation

• Patients may need to fast for a certain period before surgery.
• Medication adjustments, such as stopping blood thinners, may be necessary.
• Preoperative assessments including physical exams, blood tests, imaging studies (ultrasounds or MRIs).

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. Small incisions are made in the abdomen.
3. A laparoscope (a thin tube with a camera) is inserted to provide visuals of the internal organs.
4. Specialized surgical instruments are inserted through additional small incisions.
5. The upper part of the uterus is detached and removed, while the cervix is left intact.
6. One or both fallopian tubes and/or ovaries are detached and removed as needed.
7. The instruments and laparoscope are removed, and incisions are closed.

Duration

The procedure typically takes between 1.5 to 3 hours, depending on complexity.

Setting

The surgery is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon specializing in minimally invasive or gynecologic surgery
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Common risks: bleeding, infection, and adverse reactions to anesthesia
• Rare complications: injury to surrounding organs (bladder, intestines), blood clots, or hernias at the incision sites.
• Potential complications: management includes additional surgery or medical intervention.

Benefits

• Effective relief from symptoms of pelvic pain, heavy bleeding, or other underlying conditions.
• Minimally invasive approach means smaller incisions, less scarring, and faster recovery time.

Recovery

• Patients may go home the same day or stay overnight.
• Instructions include rest, avoiding heavy lifting, and gradual return to activities.
• Pain management may involve over-the-counter pain relievers or prescribed medications.
• Follow-up appointments to monitor healing and address any concerns.

Alternatives

• Medical management through hormone therapy or medications.
• Non-invasive procedures such as uterine artery embolization for fibroids.
• Open surgery (abdominal hysterectomy) which might involve longer recovery but could be necessary for larger uteri or complex conditions.

Patient Experience

• During the procedure: the patient is under anesthesia and will not feel anything.
• After the procedure: mild to moderate pain managed with medications; potential for bloating or shoulder pain from the gas used during laparoscopy.
• Most patients can resume normal activities within 2-4 weeks, though full recovery may take 6 weeks.