Minimally invasive surgery - Laparoscopic hysterectomy

 

Total laparoscopic hysterectomy (TLH)

Total laparoscopic hysterectomy involves removing the uterus by operating through small incisions in the abdominal wall and passing the uterus piece by piece out through those incisions or through the vagina. Very large uteruses and ovarian cysts can all be treated by laparoscopic hysterectomy. Because there is no operating through the vagina (though tiny pieces of tissue can be passed down through it), there is no requirement for a wide vagina as in LAVH. Hospital stays are one to two days and blood loss is generally very low. Post-operative pain is less than traditional vaginal or abdominal surgery and time off from work is also less.

 

This procedure offers the advantage of avoiding vaginal manipulation and incisions altogether. The entire procedure is performed laparoscopically, including the removal of the cervix.

 

As in all laparoscopic surgery, the patient must have general anesthesia. Regional anesthesia is not available.

 

Robotically-assisted TLH

During the last few years, a mechanical device that provides robotic sensitivity and accuracy to traditional laparoscopic procedures. This robot created by the da Vinci Corporation allows the performance of complicated and difficult laparoscopic procedures with greater ease than ever before. The robotically-assisted TLH is a great leap forward in the field of minimally invasive surgery and will soon be available in Danbury. The actual hysterectomy procedure is performed in a fashion identical to the normal laparoscopic procedure, but the robot provides excellent 3-D visualization, highly flexible instrumentation, and greater physical comfort for the surgeon who is seated at a control console rather than leaning awkwardly over the patient at the operating table.

 

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