Enabling a quicker recovery, fewer scars and a 4-23 hour
outpatient hospital stay, laparoscopic hysterectomy gives
women an easier alternative for definitive treatment of many
gynecologic problems.
Total Laparoscopic Hysterectomy (TLH) and Laparoscopic
Supracervical Hysterectomy (LSH) can be performed in 95% of
women needing hysterectomy. There are few contraindications
for the laparoscopic approach—even with previous c/section,
abdominal surgeries, fibroid tumors, severe endometriosis
and pelvic adhesions, most women are candidates for this
minimally invasive surgery. Recovery is superior to the
traditional vaginal hysterectomy and even Laparoscopic
Assisted Vaginal Hysterectomy (LAVH). After 4+ years and
several hundred laparoscopic hysterectomies, Dr. Jeffrey
Blake has performed more TLH/LSHs than most physicians in
Indiana, and is the only surgeon in Madison County offering
this service.
Minimally invasive surgery (MIS) continues to make strides
and advances weekly. Most of individuals are likely aware of
some of the new technology such as Robotic surgery now used
to perform such surgeries as prostate removal. Dr. Blake
continues to lead the area (Indy included) in laparoscopic
surgeries including hysterectomy, ovarian removal, and
pelvic floor reconstruction. This winter, Dr. Blake will
have been performing laparoscopic hysterectomy for 4 years.
What used to take 2-3 hours now typically can be performed
in 40-60 minutes, with many of his patients going home the
evening of their hysterectomy.
The two approaches to laparoscopic hysterectomy include the
Supracervical hysterectomy (LSH) and the Total Laparoscopic
Hysterectomy (TLH), where the entire uterus and cervix are
removed. The ovaries may or may not be removed depending on
the situation or patient preference. The discussion and
debate on whether to take or leave the cervix continues on.
Leaving the cervix results in less disruption of the female
anatomy, quicker healing and less risk of post-op infection.
It may help maintain pelvic support and possibly help with
sexual function (studies still differ on this point). Women
also must continue yearly paps (as opposed to every 3 years
if the cervix is removed), and may still experience cyclic
bleeding and pain. Removing the cervix prevents these
problems, but does result in some increased post-surgical
pain, slightly longer recovery and increased infection risk.
Additionally, some women will develop pain from the scarring
that occurs at the top of the vagina after hysterectomy,
resulting in painful intercourse.
The decision on whether or not to remove the cervix is based
on the particular reason for the hysterectomy, the patient’s
individual symptoms (such as pain or painful intercourse),
and history of abnormal paps. Whether to take or leave the
ovaries is a separate decision.
Dr. Blake is happily accepting patients who need
hysterectomy and desire this approach. It is, and should be,
the woman’s decision on how she would like her surgery
performed. Most hysterectomies (70-90%) can be performed
laparoscopically, regardless of the disease process,
patient’s size, or previous surgeries which she may have
had. It’s a shame that so many women undergo traditional
hysterectomy performed abdominally with a large scar, longer
hospital stay and much longer recovery (1-2 weeks vs. 6-8
weeks).
For more information, visit www.hysterectomyoptions.com.
