58544 Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

Name of the Procedure:

Laparoscopy, Surgical, Supracervical Hysterectomy for Uterus Greater Than 250 g with Removal of Tube(s) and/or Ovary(s)

Summary

A laparoscopic supracervical hysterectomy involves the removal of the uterus while leaving the cervix intact, using minimally invasive techniques. This procedure is recommended for larger uteri and may also involve the removal of fallopian tubes and/or ovaries as needed.

Purpose

This procedure addresses conditions such as uterine fibroids, abnormal bleeding, chronic pelvic pain, endometriosis, and certain cancers. The goals include alleviating symptoms, improving quality of life, and potentially eliminating malignancies.

Indications

• Persistent abnormal uterine bleeding
• Symptomatic fibroids
• Chronic pelvic pain unresponsive to other treatments
• Uterine prolapse
• Uterine or ovarian cancer
• Endometriosis
• Adenomyosis

Preparation

• Fasting for 8-12 hours before surgery
• Adjusting or stopping certain medications as directed by the surgeon
• Undergoing pre-operative assessments such as blood tests, imaging studies, and a complete medical history review

Procedure Description

1. The patient is positioned and given general anesthesia.
2. Small incisions are made in the abdomen.
3. A laparoscope (a thin tube with a camera) is inserted through one of the incisions.
4. Surgical instruments are inserted through other small incisions.
5. The uterus is detached in sections, keeping the cervix in place, and removed through the incisions.
6. The fallopian tubes and/or ovaries may also be removed if necessary.
7. The incisions are then closed, and the area is cleaned.

Duration

The procedure typically takes between 2 to 3 hours.

Setting

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

Personnel

• Lead Surgeon
• Assistant Surgeon(s)
• Anesthesiologist
• Nursing staff
• Surgical technologists

Risks and Complications

• Bleeding
• Infection
• Damage to nearby organs (bladder, bowel)
• Blood clots
• Anesthesia-related complications
• Postoperative pain
• Rarely, conversion to an open surgical procedure

Benefits

• Minimally invasive with smaller incisions
• Shorter recovery time and hospital stay compared to open surgery
• Reduced post-operative pain and scarring
• Alleviation of symptoms
• Potential cure of underlying malignancy

Recovery

• Short hospital stay (often same day or one night)
• Light activity encouraged soon after surgery, with gradual return to normal activities over 4-6 weeks
• Pain management with prescribed medications
• Avoiding heavy lifting and strenuous activities
• Follow-up appointments to monitor recovery

Alternatives

• Medication therapy for symptom management
• Hormonal treatments
• Uterine artery embolization
• Myomectomy
• Endometrial ablation

• Watchful waiting (in certain cases)

  Each alternative has its own pros and cons related to effectiveness, invasiveness, and suitability depending on the patient's condition.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-surgery, patients may experience some discomfort or pain managed with medications. Expect some bloating or minor vaginal bleeding. Comprehensive postoperative care and regular follow-ups ensure a smooth recovery.