Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
CPT4 code
Name of the Procedure:
Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
Common names: Laparoscopic hysterectomy with salpingo-oophorectomy
Summary
This minimally invasive surgery involves the removal of the uterus (weighing over 250 grams), and possibly the fallopian tubes and/or ovaries, using a laparoscope. The procedure is typically done to treat various conditions affecting the uterus, such as fibroids, endometriosis, or cancer.
Purpose
The procedure addresses medical conditions like large uterine fibroids, endometriosis, or malignancies of the reproductive organs. The goals are to alleviate symptoms such as pain, heavy bleeding, and improve quality of life, or to remove cancerous tissues.
Indications
- Large uterine fibroids
- Severe endometriosis
- Gynecologic cancers
- Persistent pelvic pain
- Heavy menstrual bleeding unresponsive to other treatments
- Uterine prolapse
Preparation
- Fasting for 8-12 hours before the procedure
- Review and possibly adjust current medications with your healthcare provider
- Undergo pre-operative tests such as blood work, pelvic ultrasound, or MRI
- Possibly receive a bowel prep the day before surgery
Procedure Description
- Patient is given general anesthesia.
- Small incisions are made in the abdomen.
- A laparoscope (a small camera) is inserted through one of the incisions to view the pelvic organs.
- Surgical instruments are inserted through the other incisions.
- The uterus, fallopian tubes, and/or ovaries are carefully detached and removed.
Incisions are closed with sutures or staples.
Duration
The procedure typically takes 2 to 4 hours.
Setting
Performed in a hospital's operating room or a specialized surgical center.
Personnel
- Surgeon (specializing in gynecology)
- Surgical nurse
- Anesthesiologist
- Operating room technician
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding organs (bladder, bowel)
- Blood clots
- Anesthesia complications
- Long-term pelvic pain
Benefits
- Relief from symptoms like pain and heavy bleeding
- Elimination of cancerous tissues
- Potentially quicker recovery compared to open surgery
- Smaller scars and less post-operative pain
Recovery
- Hospital stay of 1-2 days
- Avoid heavy lifting and strenuous activities for 4-6 weeks
- Follow-up appointment within 2 weeks
- Instructions on incision care and recognizing signs of complications
- Pain management with prescribed medications
Alternatives
- Medication for symptom management
- Uterine artery embolization for fibroids
- Myomectomy (removal of fibroids only)
- Endometrial ablation
- Open abdominal hysterectomy (more invasive)
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel pain. Post-procedure, some discomfort and bloating may be experienced for a few days. Pain is managed with medications. Most patients can resume normal activities within 4-6 weeks.