Total Laparoscopic Hysterectomy

The total laparoscopic hysterectomy (TLH) offers women an option that is far less invasive than other surgical approaches. The need for a hysterectomy is an important and difficult decision..

The surgical removal of the uterus can be lifesaving for those suffering from gynecological cancers or the severe pain and heavy bleeding due to fibroids or endometriosis.

Today, there are several surgical approaches that are far less invasive than a total abdominal hysterectomy, which is still widely performed. Using a laparoscope — a slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments — surgeons have the ability to see inside the abdomen and technical access to the uterus, ovaries and fallopian tubes without having to make a large incision.

In the past few years, many gynecologists have performed a portion of the hysterectomy using a laparoscope. Called a laparoscopically assisted vaginal hysterectomy (LAVH), the procedure requires an incision deep within the vagina, through which the uterus and related organs are removed. The LAVH still involved a transvaginal approach and decreased healing time, similar to a total vaginal hysterectomy.

With advanced laparoscopic skills, gynecological surgeons are able to perform TLH. The surgery is completed utilizing only four tiny abdominal incisions less than one-quarter to one half an inch in length. Even a large uterus can be removed laparoscopically using this technique. A traditional open hysterectomy requires an abdominal incision of four to eight inches.