Advanced Medical Directive
CHANGE CHANGE CHANGE: Laparoscopic technology has been steadily improving allowing increasingly complex procedures. The “Minimally Invasive” surgical process involves operating inside the abdomen through very small incisions while watching a video monitor. The use of newer High-frequency sound or Tissue fusion devices has replaced the old laser technology for nearly all Laparoscopic surgeries. Usually, three tiny 5 mm incisions are made in the patient’s abdomen to accomplish a Laparoscopic Hysterectomy. The procedure involves removal of the uterus and tubes. The ovaries are usually left in place but may be removed for ovarian cancer risk, endometriosis or other specific reasons.
BENEFITS: most women experience less pain, shorter hospital stay, and quicker recovery time (just ten to fourteen days). Other interests include less risk of surgical complications, scar tissue and infection. Furthermore, there is better long-term support of the top of the vagina which may protect sexual health and allow earlier return to regular sexual activity. For obese patients, this approach may be better than the other options. The day after surgery most patients are up and dressed, eating their breakfast and preparing for dismissal. One of the common problems following total abdominal hysterectomy is vagina falling due to poor supports. Laparoscopic Hysterectomy preserves the pelvic floor supports.
CONCLUSION: Simply put, this Minimally Invasive procedure allows patients to return to their normal lives sooner. After this surgery, patients are generally sore and have a little difficulty getting up and down, but don’t feel marked pain. If they chose, women could usually return to work in two weeks (four to five weeks sooner than with abdominal hysterectomy), and this has a tremendous economic and personal impact.
Hysterectomy is performed on more than 600,000 women each year in the United States usually through a six-inch abdominal incision that requires two to four days in the hospital and a four to six week recovery time. This is one of the most commonly performed surgical procedures. Reasons for hysterectomy include abnormal menstrual bleeding, smooth muscle tumors of the uterus (also called myomas or fibroids) and a variety of pelvic pain disorders. Vaginal hysterectomy is one traditional alternative to abdominal hysterectomy. The vaginal approach is performed by removing the uterus through an incision in the vagina. It does require a shorter two-day hospital stay and four-week recovery period.
TOTAL LAPAROSCOPIC HYSTERECTOMY
Total Laparoscopic Hysterectomy (TLH) is one procedure, one anesthesia and is Definitive.
TLH reduces cancer risk for the uterus and cervix (and ovaries if they are removed).
TLH eliminates the need for future Pap smear screening.
TLH eliminates the need for future diagnostic evaluation of abnormal vaginal bleeding.
TLH eliminates the risk of pregnancy, therefore, no Vasectomy or Tubal Ligation is required.
TLH allows the safer “estrogen only” hormone replacement therapy in the menopause.
TLH is associated with high patient satisfaction and usually does not impact sex drive, urine control or prolapse.
HYSTERECTOMY: should I keep my ovaries?