Vaginal Hysterectomy Assisted with Laparoscopy
A vaginal hysterectomy involves the removal of the uterus and cervix through the vagina. A laparoscope is a small tube with a light and camera at one end. It allows the surgeon to see the inside of the pelvic cavity without making a big cut in the skin. The ovaries and fallopian tubes may also be removed in this procedure.
Who is a candidate for the procedure?
A vaginal hysterectomy assisted with laparoscopy may be used for the following problems:
abnormal cells in the lining of the uterus or cervix that are suspicious for very early cancer
abnormal or heavy bleeding from the uterus
adenomyosis, or noncancerous tumors made of gland tissue and muscle
chronic pelvic pain
endometriosis, a condition in which small pieces of the uterus lining attach to tissue outside the uterus
fibroids, which are noncancerous tumors that grow in the muscle of the uterus
pelvic inflammatory disease, or widespread infection of the pelvic organs
uterine prolapse, a condition in which the uterus drops from its normal position at the top of the vagina
How is the procedure performed?
Before surgery, several things are usually done.
The abdomen and vulvar area, which is the area between the legs, are sometimes shaved.
An anesthesiologist meets with the woman. He or she will discuss the anesthesia options and allergies to medicines.
An intravenous line, or IV, is placed in a vein, usually in the hand or arm. The IV can be used to replace fluids and give medicine or a blood transfusion.
Medicines, such as sedatives, are given.
A urinary catheter is placed in the bladder to drain urine.
In the operating room, a small incision is made below the navel to place the laparoscope. The stomach is then inflated with gas so that the surgeon can see clearly inside the body. Other surgical tools are placed through two small cuts in the lower part of the belly. These are used to cut the tissues, such as blood vessels, that surround the uterus and cervix. These tissues must be cut and tied off before the uterus is removed. The uterus is then removed through the vagina. The vagina is closed with sutures at the top.
The surgery usually takes 60 to 90 minutes. At times, the ovaries and tubes or other structures may be removed or repaired during the procedure.