Laparoscopic Assisted Vaginal Hysterectomy

Laparoscopic Hysterectomy

Hysterectomy

Hysterectomy is the surgical removal of the uterus. 
Click image to enlarge
Image courtesy of Gyrus ACMI

What exactly is Laparoscopic Hysterectomy?

Laparoscopic hysterectomy is removal of the uterus through small incisions on the abdominal wall. Hysterectomies can either be partial or total. A total hysterectomy means that we are removing the uterus, cervix, fallopian tubes and ovaries. A partial hysterectomy implies that we are not removing either the cervix or the ovaries or both. Laparoscopic hysterectomy has the benefit of having a shorter hospital stay and recovery with less pain due to smaller incisions. Laparoscopic assisted Vaginal Hysterectomy is done when we are removing the cervix.  Ovaries can be removed or left in place. 

Who is not a candidate for Laparoscopic Hysterectomy?

If you have an indication for hysterectomy, the majority of the time, you are a candidate for laparoscopic hysterectomy. Only if the uterus is too large that it obstructs the ability to see around it, or if there is scar tissue that limits the ability to see or operate safely, would you not be a candidate for Laparoscopic Hysterectomy.

Hysterectomy

Incision points for laparoscopic hysterectomy
Click image to enlarge
Image courtesy of Gyrus ACMI

How is Laparoscopic Hysterectomy performed?

In the hospital, under general anesthesia, three small (1 cm) incisions are made on the abdomen, one near the belly button and the others on the right and left side of the lower abdomen. A needle is placed into the abdomen and we fill the abdominal cavity with CO2 gas so that we can see. Trocar ports, or plastic tubes, are place through the incisions. A camera is placed through the belly button incision and laparoscopic instruments are placed through the other two ports to do your surgery. During the abdominal portion of surgery, the ligaments and blood vessels of the uterus are cauterized and separated from the pelvic ligaments.  Vaginally, we will remove the cervix and uterus through the vaginal incisions. We often remove the fallopian tubes ever if leaving the ovaries as it is thought that a component of what is considered to be ovarian cancer, may in fact be fallopian tube cancer. 

Why would I leave my ovaries?

Ovaries function to produce hormones. If we remove the ovaries, we are, in effect, creating a “surgical menopause”. If you are postmenopausal, there is no reason to leave your ovaries in place and we would recommend consideration of removal to minimize the risk of future ovarian cancer which is hard to detect early. If you are pre-menopausal and your ovaries appear normal, we will often recommend we leave the ovaries in place to minimize the side effects associated with menopause such as hot flushes, mood changed, vaginal dryness. If you are perimenopausal and already experiencing a lot of these symptoms, then it would be a personal choice to leave the ovaries or remove them.

Hysterectomy

Laparascopic comparison charts.

How many laparoscopic hysterectomies has Dr. Martinez performed?

Dr. Martinez trained at St. Joseph Hospital in Houston from 1992-1996 and received extensive laparoscopic training in hysterectomies as well as all laparoscopic surgeries including treatment of fibroids, ovarian cysts, endometriosis and pelvic pain. Dr. Martinez performs the majority of her hysterectomies laparoscopically due to the optimized 2-4 week recovery time and overnight hospital stay associated with laparoscopic hysterectomy. Abdominal hysterectomy requires, on average, a three day postoperative stay with a 6-8 week recovery. Dr. Martinez tries to avoid hysterectomy whenever possible by utilizing alternative, minimally invasive procedures, such as her in- office Thermachoice Endometrial Ablation. However, when hysterectomy is indicated, Dr. Martinez is an extremely experience surgeon in this technique and has performed over 500 laparoscopic hysterectomies to date.

When is hysterectomy indicated?

Hysterectomy is indicated for treatment of heavy bleeding, painful periods, fibroids, endometriosis, recurrent ovarian cysts, endometrial hyperplasia, recurrent abnormal pap smears, and uterine cancer.

Please call our office today to schedule a consultation at 505-988-4922.

Testimonials

“This is not ‘your mother’s hysterectomy’. We’ve all heard the horror stories. Forget it! That was then, this is now. If you are a candidate (for laparoscopic hysterectomy), I would highly recommend this procedure to you – minimal stay in hospital, minimal scars, minimal discomfort, and minimal time away from your life. I am so thankful for this procedure, and to Dr. Martinez and her team.” – Vicki

“I had very little discomfort from the (laparoscopic hysterectomy) procedure. The nurses in the hospital asked me if I had really had surgery, and I was able to get up and walk the day of surgery with little pain. I would recommend Dr. Martinez and her staff to all of my friends and family.” – Windy