Dr Sarthak Sidapara

Laparoscopic Hysterectomy

Laparoscopic Hysterectomy

Hysterectomy is the procedure that removes the uterus, ovaries, fallopian tubes, and cervix. There are many ways to conduct this procedure, Laparoscopy is one of them. Laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. It is a safe & effective process. A tiny camera is inserted through the belly button which allows doctors to see a patient’s internal organs. This procedure takes place under anesthesia. In Some cases, a woman’s uterus is removed, but not the cervix, this procedure is laparoscopic supracervical hysterectomy.

Why is it performed?

Doctors perform laparoscopic surgery is suggested when the patient is suffering from any of the following conditions:-

  • Chronic pelvic pain
  • Endometriosis
  • Pelvic inflammatory disease
  • Infertility
  • Removal of fibroids, uterus, lymph nodes, and ovarian cysts
  • Ectopic pregnancy

How is Laparoscopic hysterectomy performed?

The various steps takes place in the process of laparoscopy:-

  • Preparation and positioning
  • Insertion of a urine manipulator
  • Abdomen entry and placement of trocar
  • Hug the ovaries
  • Mobilization of the bladder
  • Secure the urine vessels
  • The uterus and cervix is separated from the vaginal apex
  • Removal of the uterus
  • Closure of vaginal cuff
  • Closure of the port site

10 Reasons for Hysterectomy

1. Uterine Fibroids
Sometimes there is a noncancerous growth of fibroids in the uterus also. They can furthermore cause pain and heavy bleeding. If other measures fail then doctors will have no choice other than hysterectomy.

2. Cancer
Need for hysterectomy is when you have cancer of the following:

In case of precancerous conditions or to avoid cancer in the future, doctors also recommend surgery.

3. Endometriosis
Endometriosis is caused when the tissues that line the uterus grows outside. It can cause irregular periods. Some extreme pain ultimately leading to infertility also happens.

Before hysterectomy is performed in the case of endometriosis, medical procedures and hormone therapy are done.

4. Adenomyosis
Adenomyosis is caused when the lining of the uterus starts growing into the muscle of the uterus. This leads to the thickening of the uterus wall. It causes heavy bleeding and pain.

In the case of adenomyosis also, hormone therapy and medications are tried first.

5. Infection
PID also is known as Pelvic Inflammatory Disease leads to severe pelvic pain. It is due to bacterial infection. If found at an early stage, it can get better with antibiotics.

But once it spreads it can damage the uterus. Hence doctors suggest a hysterectomy if you have a severe pelvic inflammatory disease.

6. Hyperplasia
When the lining of the uterus is too thick it causes hyperplasia. Consuming too much of estrogen causes hyperplasia also. Heavy, irregular menstrual bleeding takes place because of hyperplasia also.

It can also lead to uterine cancer. If doctors suspect severe hyperplasia they might recommend a hysterectomy also. Doctors recommend hysterectomy because that will lead to cancer in the future.

7. General abnormal bleeding
If you experience irregular and heavy menstrual bleeding regularly doctors may recommend a hysterectomy. Irregular bleeding takes place because of fibroids, cancer, infection, hormone changes, and other conditions. Stomach pains and cramps accompany these causes.

The only way to get relief after all the hormone therapies is hysterectomy.

8. Uterine prolapse
When the uterus slips and falls into the vagina from its normal place it is the uterine prolapse. It is also very common in women who is having multiple vaginal births. In some cases where women suffer from obesity or menopause this is also common.

Some of the common symptoms of uterine prolapse are:

Urinary issues
Pelvic pressure
Bowel problems
The nature of treatment mostly depends upon how severe the uterine prolapse is. If all other measures don’t work, doctors furthermore recommend a hysterectomy.

9. Placenta accreta
When the placenta grows into the uterine wall too deeply, it causes placenta accreta. This happens during the time of pregnancy. It does not cause any symptoms and conditions are very serious.

In such a case doctors go for cesarean delivery along with hysterectomy. It prevents the loss of blood when the placenta is separated.

10. Delivery complications
Sometimes severe bleeding occurs in case of cesarean or vaginal delivery also. Doctors perform a hysterectomy and take out your uterus. Furthermore this is just after the delivery to save a life.

What are the alternatives to a hysterectomy?
Uterine artery embolization
Medical management

Tests performed before hysterectomy

Doctors may prescribe for preliminary blood tests, an electrocardiogram (EKG), a urinalysis, and a chest x-ray before hysterectomy. It helps to make sure there are no medical problems that are undiagnosed. If not diagnosed they can create problems during the time of surgery also.

To evaluate the ovaries and uterus, a pelvic ultrasound may be done. It depends upon the physical exam and medical history of the patient.

Many tests are done before hysterectomy. Such as:

  • CBC count
  • Endometrial sampling
  • Ultrasonography
  • ECG
  • CAT scan
  • Barium enema
  • Tumor markers
  • Blood type cross match
  • Chest radiography
  • Papanicolaou test
  • Cystoscopy

Types of hysterectomy

There are four types of hysterectomy

  • A radical hysterectomy
  • A total hysterectomy
  • Super cervical hysterectomy
  • Hysterectomy with oophorectomy

Uterus removed side effects

The uterus is the female reproductive organ. It is a location in between the rectum and the bladder. There are two parts of the uterus – the cervix ( main part ) and the cervix ( lower part ). It nourishes and houses the fertilized egg until the newborn is born. It is the womb where the baby grows.

You may need a lot of reasons for removing the uterus. Removing the uterus is to treat certain types of infections and cancer. At the same time, there lie many side effects of removing the uterus:

  • Menopause – You will no longer experience menstrual cycle
  • Sense of loss
  • Change in the sexual feeling
  • Risks of other health problems increase

Hysterectomy recovery

There are many tips you may follow after hysterectomy. You must also know how to handle emotional and physical ups and downs.

  • Engage yourself with some exercises or yoga
  • Get some sunshine
  • Take medications according to the prescribed time
  • Take as much rest as you can
  • Prevent yourself from constipation
  • Try to wear loose, stretchy clothing
  • Eat healthy foods also
  • Talk to your friend about your feelings
  • Make yourself emotionally ready for hormone changes
  • Let your close ones also help you
  • Do not wait to call your doctor if you are not feeling well

The pros and cons of laparoscopic hysterectomy


  • Laparoscopic hysterectomy involves minimally invasive techniques. These are far better than the traditional methods
  • Instead of waiting for a long time and staying at the hospital, this takes place in a short time
  • There is minimum pain, little to no blood loss. And there are also minimal risk in case of laparoscopic surgery


  • Laparoscopic hysterectomy may cause a higher risk of cardiovascular diseases also
  • It also premature menopause

Laparoscopic hysterectomy time

Usually, it takes about 1 to 3 hours if it is done under general anesthesia. Many patients are also hospitalized for one night because the doctor can monitor the healing progress. The maximum of the patients returns to normal activities with 5-6 days as well.

What to expect after laparoscopic hysterectomy?

  • Some women who undergo laparoscopic hysterectomy may also expect to have smears. This takes place from the top of the vagina
  • You will also be offered hormone replacement therapy
  • You will also be advised to rest comfortably and move easily
  • A feeling of tiredness and discomfort will be in your body for the first few days

Life after hysterectomy

Life after hysterectomy will not be the same as before. You will not be experiencing a regular menstrual cycle. One will get relief from the pains that lead to laparoscopic surgery.

You will also not be able to conceive anymore.

Laparoscopic hysterectomy cost

On average, the cost of laparoscopic hysterectomy in India is Rs. 2,10,000 to Rs. 3,00,000. This cost is without any medication or physiotherapy prescribed by the doctor. The cost mainly depends upon the condition of the patient.

According to reports, laparoscopic hysterectomy is a much safe and effective procedure. This is safest method of removing the uterus compared to the traditional methods also.