Name of the Procedure:

Laparoscopy, Surgical, with Total Hysterectomy, for Uterus 250g or Less; with Removal of Tube(s) and/or Ovary(s)

Summary

This minimally invasive surgical procedure involves the removal of the uterus, and possibly one or both fallopian tubes and ovaries, through small incisions in the abdomen. It is completed using a laparoscope, a thin tube with a camera.

Purpose

This procedure aims to treat various gynecological conditions, such as uterine fibroids, endometriosis, chronic pelvic pain, and gynecologic cancers. The goal is to alleviate symptoms, improve quality of life, and sometimes prevent the spread or recurrence of cancer.

Indications

• Symptomatic fibroids causing pain or heavy bleeding
• Endometriosis unresponsive to other treatments
• Chronic pelvic pain
• Uterine, ovarian, or fallopian tube cancer
• Severe abnormal uterine bleeding
• Prolapsed uterus

Preparation

• Fast for 8-12 hours before the procedure
• Adjust or stop certain medications as directed by the doctor
• Undergo preoperative diagnostic tests, such as blood tests, ultrasound, or a pelvic exam

Procedure Description

1. General anesthesia is administered.
2. Small incisions are made in the abdomen.
3. A laparoscope is inserted through one incision to provide a visual guide.
4. Surgical instruments are inserted through other incisions.
5. The uterus is detached and removed through the incisions.
6. If necessary, one or both fallopian tubes and/or ovaries are also removed.
7. Incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes between 2-3 hours.

Setting

Performed in a hospital or surgical center.

Personnel

• Surgeon (gynecologist specializing in laparoscopic surgery)
• Anesthesiologist
• Surgical nurses
• Possibly a surgical assistant

Risks and Complications

• Common: infection, bleeding, pain, adverse reaction to anesthesia
• Rare: injury to surrounding organs (bladder, bowel), blood clots, hernia, long-term complications

Benefits

• Relief from symptoms like pelvic pain or heavy bleeding
• Potential cure or prevention of cancer
• Minimally invasive approach results in less postoperative pain and quicker recovery
• Shorter hospital stay compared to open surgery

Recovery

• Most patients can go home the same day or within 24 hours
• Recovery typically takes 2-4 weeks
• Post-procedure instructions include rest, avoiding heavy lifting, and managing pain with prescribed medications
• Follow-up appointments to monitor healing

Alternatives

• Medication therapy for symptom management
• Hormone treatments
• Endometrial ablation for abnormal bleeding
• Myomectomy for fibroid removal while preserving the uterus
• Traditional open hysterectomy

Patient Experience

Patients may experience discomfort, pain, and fatigue initially, managed with pain-relief medications. Small scars and slight bruising at incision sites are common. Proper rest and following post-procedure instructions promote smoother recovery.