Barbra S. Hanna, D.O.
Heather A. Cushing, M.D.
Minimally Invasive Hysterectomy

What is a Hysterectomy?
A hysterectomy is the surgical removal of all or part of the uterus. If you suffer from pelvic pain, excessive menstrual bleeding or uterine fibroids a hysterectomy may be the best option to treat your problem. You do not have to have your ovaries or tubes removed at the time of hysterectomy unless they are diseased.

Benefits of Minimally Invasive Hysterectomy
Minimally invasive procedures for hysterectomy are:
  • Laparoscopic supracervical hysterectomy (LSH)
  • Total laparoscopic hysterectomy (TLH)
  • Laparoscopic assisted vaginal hysterectomy (LAVH)
  • Vaginal hysterectomy (VH)

A minimally invasive hysterectomy is performed by making either 3 small (1/2 inch) incisions on the abdomen, an incision in the vagina or a combination of both techniques. These techniques result in less post-operative pain, a quicker recovery and fewer complications with less scarring. The hospital stay is usually less than 24 hours. Return to normal activity is about 2 weeks. The minimally invasive hysterectomy was developed to reduce pain and surgical trauma, minimize scarring and shorten recovery time.

Most women are appropriate candidates for a minimally invasive hysterectomy. Careful exam by an experienced and qualified surgeon can determine which minimally invasive hysterectomy is appropriate for you. The physicians at Associates in Gynecology are experienced in all types of minimally invasive hysterectomy. They successfully perform over 95% of their hysterectomy procedures using a minimally invasive technique.

Laparoscopic Supracervical Hysterectomy (LSH)
Many gynecologic problems involving the uterus are localized to the top of the uterus, and there is no need to remove the cervix or ovaries. This surgical technique involves general anesthesia and uses laparoscopy alone to remove the uterus, but leaves the cervix attached to the vagina. You will have three small incisions (one in the navel and one in the left and right lower aspect of your abdomen in the bikini line). Since the cervix is left in place, there are no incisions in the vagina. While extremely uncommon, it is possible that a small amount of uterine tissue is left near the cervix, causing scant bleeding to occur with the menstrual cycle in 5-20% of women.

During the LSH procedure, a laparoscope (thin lighted telescope) and small surgical instruments are inserted through the tiny incisions. Using these instruments, the surgeon is able to carefully separate the uterus from the cervix and then remove it through one of the small incisions.

A supracervical hysterectomy does not refer to the removal of the ovaries and tubes. These organs may or may not be removed at the time of a supracervical hysterectomy.

Most women have a 23-hour observation stay in the hospital and return to normal activity including intercourse in usually about fourteen days. Because the cervix is left in place, a woman should be willing to get regular Pap smears to screen for cervical cancer. Leaving the cervix also requires that a woman have adequate support to the top of her vagina.

Total Laparoscopic Hysterectomy (TLH)
This procedure also involves general anesthesia and removes the uterus and cervix with the laparoscope. Similar to the SLH, you will have 3 small incisions (1 in the navel and 1 in the left and right lower aspect of your abdomen in the bikini line). The TLH is performed entirely with the laparoscope. A TLH is usually recommended when removal of the uterus and cervix is desired and the patient has no relaxation in the vagina.

Most women have a 23-hour observation stay in the hospital stay and return to normal activity in 14 days. Since there is an incision at the top of the vagina from removal of the cervix, return to intercourse is usually 6 weeks or until complete healing.

Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
This technique is similar to the TLH but requires additional surgical skills and instruments to remove the uterus and cervix thru an incision made in the vagina. A laparoscope is used to facilitate the removal of the uterus, cervix and tubes and ovaries if desired. The surgeon then utilizes a vaginal approach to make an incision in the vagina at the apex to remove the organs. This procedure is usually recommended for patients that have relaxation in the vagina, mild pelvic organ prolapse (cystocele, rectocele, uterine prolapse) or urinary incontinence, which requires additional vaginal procedures at the time of hysterectomy. Similar to the TLH, you will have three small incisions (one in the navel and one in the left and right lower aspect of your abdomen in the bikini line) and an incision at the top of the vagina.

This surgery is performed under general anesthesia. Most women have a 23-hour observation stay in the hospital and return to normal activity in 14 days. Since there is an incision at the top of the vagina from removal of the cervix, return to intercourse is usually 6 weeks or until complete healing of the vagina.

Total Vaginal Hysterectomy (TVH)
The uterus and cervix are removed through an incision deep within the vagina. This method can be used when the uterus is not too enlarged or when surgical repair of pelvic organ prolapse is done at the same time, such as with repair of the bladder, rectum or for surgical treatment of urinary incontinence.

This surgery is performed under general, spinal or epidural anesthesia and requires an overnight stay in the hospital. The recovery period is usually 14-21 days. Since there is an incision at the top of the vagina from removal of the cervix, return to intercourse is usually 6 weeks or until complete healing of the vagina. This method offers the lack of any visible scarring since there are no abdominal incisions.

Associates in Gynecology, Ltd.
1604 North Main Street  •  Wheaton, Illinois 60187
630-260-1818