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Hysterectomy - Laparoscopic

Laparoscopic hysterectomy refers to a variety of surgical procedures which are accomplished with the aid of a slender optical tube known as a laparoscope. Hysterectomies performed in this manner may result in less time spent in the operating room and shorter recovery times than similar abdominal procedures. There may also be fewer and smaller scars than those left from abdominal hysterectomies. For these reasons many women are now requesting laparoscope assisted operations. How is a laparoscopic hysterectomy performed and who might be an appropriate candidate for one?

A basic laparoscopic hysterectomy begins with a short incision below the woman’s navel. The laparoscope is inserted through this cut. After the doctor has examined the pelvic cavity via the laparoscope additional incisions will be made. Narrow surgical instruments will then be introduced to the area through the secondary cuts. Using the laparoscope to guide the surgery, the doctor will then cut the uterus away from the patient’s body. The organ will be cut into strips small enough to be removed through the incisions which have been made into the abdomen. Once the uterus has been taken out in this fashion only a few short stitches are need to close the cuts.

Two variations on the common laparoscopic hysterectomy are the laparoscopically assisted vaginal hysterectomy and the laparoscopic supracervical hysterectomy. One of the disadvantages of a standard vaginal hysterectomy is the inability of the surgeon to view the pelvic area and to see the other reproductive organs. By enlisting the aid of a laparoscope when performing a hysterectomy vaginally, the doctor can more fully ascertain the condition of the reproductive area as a whole.
A laparoscopic supracervical hysterectomy provides for the uterus to be removed while leaving the cervix intact. The cervix acts as support for many of the pelvic ligaments; not taking it out adds to the post hysterectomy stability of the entire reproductive area. It is also thought that excising the cervix can result in vaginal dryness and decreased sexual response. For these reasons, the laparoscopic supracervical hysterectomy is gaining favor amongst many women and their physicians.

Unfortunately, the uterine conditions that can be treated by some type of laparoscopic hysterectomy are limited. Laparoscopic operations are appropriate for small to medium size uterine fibroids. They may also be successfully performed for less severe cases of endometriosis and for unusual bleeding. If a woman’s ailment has caused her uterus to grow much beyond normal size she generally is not a good candidate for laparoscopic hysterectomy.

Even a laparoscopic hysterectomy is major surgery which should not be contemplated without thorough research. As long as a physician does not feel that a woman is jeopardizing her health, she may want to try remedies for her condition which stop short of hysterectomy. However, once it has been determined that a hysterectomy is necessary, many women may want to discuss the possibility of having an operation which is less invasive than a conventional abdominal procedure. If her condition allows and after close consultation with her physician, a woman may find that a laparoscopic hysterectomy can be the best solution to her problem.

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