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Total Laparoscopic Hysterectomy (TLH)

Overview

Total Laparoscopic Hysterectomy (TLH) is a minimally invasive surgical procedure that involves the removal of the uterus through small incisions in the abdomen using a laparoscope. This technique offers several advantages over traditional open surgery, including less postoperative pain, shorter recovery times, and minimal scarring.
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Neelam B Vaid
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Nitika Sharma
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Payal Modi
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How is Total Laparoscopic Hysterectomy (TLH) Done?

Preoperative Assessment:
  • Detailed medical history and physical examination.
  • Blood tests, imaging studies (like ultrasound or MRI), and possibly a biopsy to assess the condition of the uterus and surrounding structures.
  • Evaluation of any existing medical conditions that may impact surgery.
Medications:
  • Review and adjustment of current medications.
  • Possible prescription of antibiotics to prevent infection.
Dietary Restrictions:
  • Instructions regarding fasting before surgery, usually from midnight prior to the procedure.
Preoperative Counseling:
  • Discussion of risks, benefits, and expected outcomes with the surgical team.
  • Informed consent process.
Lifestyle Adjustments:
  • Smoking cessation if applicable.
  • Arranging for post-operative care or support at home.

  • Anesthesia: General anesthesia is administered for patient comfort during the procedure.
Surgical Technique:
  • Small incisions (usually 3-4) are made in the abdomen.
  • A laparoscope (a thin, lighted tube with a camera) is inserted through one of the incisions to provide visual access to the pelvic organs.
  • Surgical instruments are inserted through other incisions to perform the hysterectomy.
  • The uterus is detached from the surrounding structures (ligaments, ovaries) and removed from the body through the vagina or through one of the abdominal incisions.
Closure:
  • Incisions are closed with sutures or adhesive strips, and sterile dressings are applied.

  • Intraoperative Complications: Bleeding, injury to surrounding organs (bladder, intestines), or blood vessel damage.
  • Postoperative Complications: Infection, blood clots, or complications related to anesthesia.
  • Long-term Complications: Changes in hormone levels, pelvic floor disorders, or vaginal prolapse.
What are the Benefits of Total Laparoscopic Hysterectomy (TLH) ?
  • Minimally Invasive: Smaller incisions lead to less postoperative pain and quicker recovery.
  • Shorter Hospital Stay: Many patients can go home within 24 hours after the procedure.
  • Faster Return to Daily Activities: Typically, patients can resume normal activities in 2-6 weeks.
  • Less Scarring: Small incisions result in minimal visible scars.
  • Reduced Risk of Infection: The laparoscopic approach generally leads to a lower rate of postoperative infections compared to open surgeries.
Specialty
  • Gynecology

Infrastructure Facilities

  • Surgical Unit: Equipped with advanced laparoscopic surgical instruments, cameras, and imaging technology.
  • Anesthesia Facility: Access to a team of anesthesia providers and monitoring equipment for patient safety.
  • Recovery Room: Post-anesthesia care unit (PACU) for monitoring patients after surgery.
  • Inpatient Facilities: Comfortable accommodations for overnight stays if necessary, with nursing support.
  • Emergency Services: Immediate access to surgical teams and resources in case of complications.

FAQs

TLH usually takes about 2-4 hours, depending on the complexity of the case.

Most patients can expect to return to normal activities within 2-6 weeks.

Yes, alternatives include abdominal hysterectomy, vaginal hysterectomy, and medical management options depending on the condition being treated.

Some discomfort is normal, but pain is typically managed with medications.

Yes, the surgeon may choose to leave the ovaries intact if they are healthy and not affected by the underlying condition.

Signs of complications include severe pain, heavy bleeding, fever, or signs of infection at the incision sites.

If the ovaries are removed, hormonal changes may occur. If they are preserved, hormone levels should remain stable.

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