Laparoscopic Hysterectomy
Laparoscopic hysterectomy is removal of uterus laparoscopically – when it is causing various problems.
Removal of uterus-Hysterectomy was traditionally done either by making large vertical or horizontal cut over the abdomen or vaginally.
Dr. Harry Reich from USA was the first person to remove uterus laparoscopically in 1988. Today Lap. Hysterectomy is a highly practical and useful technique also associated with more postoperative comfort, a shorter hospital stay, and a more rapid recovery and return to work and normal acts of daily living, has been widely adopted by us at Yashadaa. Almost all hysterectomies are done laparoscopically.
We use modern equipments like Cord less ultrasound dissector- Sonicision, Hormonic and modern electro surgery unit to perform this operation. Largest uterus removed in our operation theatre was as large as 6-7 months pregnant uterus (Reaching above the level of navel) During Laparoscopic hysterectomy main incision is taken at or near the umbilicus-navel from which laparoscope goes inside. Carbon di-Oxide gas goes inside the abdominal cavity to distend/ bloat the cavity. We call it as a pneumoperitoneum. Once pneumoperitoneum is created, three or four more incisions are made on either of the sides.
Various instruments go inside the abdominal cavity and surgery is performed. The uterus and or both the fallopian tubes and ovaries are separated from the normal structures using various techniques and energy sources. Traditionally the various structures used to be separated by ligating them or by using bipolar current. Now a days with advances in technology various energy sources are used such as vessel sealers, ultrasound dissectors etc.
We use ultrasound dissectors and vessel sealers to do this job. Surgery done using ultrasound dissector is safer & faster than the conventional equipments.
After separating uterus from normal structures we remove the uterus out of the abdominal cavity either through vagina or from one of the abdominal port by the process of morcellation.
Morcellation is the process by which the uterus it is stripped in to small 1-1.5 cm diameter strips looking like finger chips which are removed out of body through 1-1.5 cm incision.
Laparoscopic hysterectomy is safe, less painful. Patient recovery is very fast as compared to traditional hysterectomy. Patient can be discharged practically on very next day of the surgery.
Laparoscopic hysterectomy may have some complications, such as injury to urinary bladder, intestines or ureter or major blood vessels. Rate of such complications is as low as 1 % but such complications can also occur in traditional hysterectomies.
