In general, patients may need to be mentally and physically ready to accept the aftereffects of laparoscopic hysterectomy:
- The first 24 hours after hysterectomy, patients may experience some vaginal bleeding that tapers off. If the bleeding seems to be getting heavier rather than lighter, the physician should be notified immediately.
- The patient may feel extremely tired afterward; the tiredness may last for up to several weeks. Try to take frequent rest breaks to gradually regain strength.
- For several weeks, the patient may have vaginal discharges that appear bloody at first, then it gradually becomes thinner and lighter over time.
- If both ovaries are removed, the patient may experience symptoms of menopause, including hot flashes, night sweats, and vaginal dryness. If necessary, the physician may recommend hormone replacement therapy to help alleviate discomfort.
- The patient may have a sense of loss that causes depression and decreased appetite, concentration, and sleep. These feelings and reactions are normal and should diminish with time. If they persist or significantly disrupt life, patients are encouraged to talk with the physician or a supportive care provider, such as a psychologist.
- Patients after laparoscopic hysterectomy recover after 3-4 weeks.
The physician should be immediately notified if
- Patients experience fever or other signs of infection
- Heavy bleeding (soaking through a pad in less than one hour)
- Severe pain that does not respond to medications
- Nausea or vomiting
- Diarrhea or constipation
- Difficulty urinating or a foul odor from your vagina
What is a laparoscopic hysterectomy?
Laparoscopic hysterectomy is the surgical removal of the uterus. The procedure is usually done under general anesthesia.
- A laparoscope is a thin, lighted tube with a camera that is inserted into the abdomen through a small incision in or around the navel. It allows the surgeon to see the pelvic organs on a screen. Additional small incisions are made in the abdomen for other instruments used in the surgery.
- Three to four small cuts may be made in the abdomen. A cut is also made in the vagina. Probes and tools are inserted into the small incisions. The uterus and cervix are removed (possibly, ovaries and fallopian tubes) through the vagina and through the incisions. The vagina is then sewn back.
There are three kinds of laparoscopic hysterectomy:
- Total laparoscopic hysterectomy: A small cut is made in the navel for the laparoscope, and one or more small cuts are made in the abdomen for other instruments. The uterus is detached from inside the body. It is then removed in small pieces through the incisions, or the pieces are passed out of the body through the vagina. If only the uterus is removed and the cervix is left in place, it is called a supracervical laparoscopic hysterectomy.
- Laparoscopically assisted vaginal hysterectomy: A vaginal hysterectomy is done with laparoscopic assistance. For example, the ovaries and fallopian tubes may be detached using laparoscopy, and then, the uterus is detached and all the organs are removed through the vagina.
- Robot-assisted laparoscopic hysterectomy: Some surgeons use a robot attached to the laparoscopic instruments to help perform the surgery. It allows for more complex cases to be performed in a minimally invasive fashion allowing for faster patient recovery.
Benefits of laparoscopic hysterectomy:
- The cuts are smaller, and there may be less pain.
- The hospital stay after laparoscopic surgery may be shorter.
- The patient may be able to return to normal activities sooner.
- The risk of infection is lower.
Disadvantages of laparoscopic hysterectomy:
- It often takes longer to perform laparoscopic surgery compared with abdominal or vaginal surgery. The longer you are under general anesthesia, the greater the risks for certain complications.
- Also, there is an increased risk of bladder injury in this type of surgery.
Types of hysterectomy:
- Total hysterectomy: The most common type of hysterectomy, this surgery removes the entire uterus, including the cervix. The ovaries and the fallopian tubes may or may not be removed.
- Partial hysterectomy: This is also called subtotal or supracervical hysterectomy. In this procedure, only the upper part of the uterus is removed. The cervix is left in place. The ovaries may or may not be removed.
- Radical hysterectomy: All of the uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina are removed. This is often used to treat certain types of cancer like cervical cancer. The fallopian tubes and the ovaries may or may not be removed.
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References
Laparoscopic Hysterectomy, https://emedicine.medscape.com/article/1839957-overview
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