Total Laparoscopic Hysterectomy

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What is Total Laparoscopic Hysterectomy (TLH)?

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Definition

Total laparoscopic hysterectomy (TLH) is a minimally invasive surgical procedure used to:

  • Remove the uterus and cervix.
  • Occasionally includes the removal of fallopian tubes and ovaries.
  • Performed using small incisions and a laparoscope (a thin, lighted tube with a camera).

Purpose

  • Treats gynecological conditions like fibroids, endometriosis, or abnormal bleeding.
  • Used for uterine cancer management.
  • Resolves chronic pelvic pain and prolapse issues.

When is it recommended?

  • Uterine fibroids causing heavy bleeding or pain.
  • Endometriosis unresponsive to medication.
  • Gynecological cancers (uterine, cervical, or ovarian cancer).
  • Chronic pelvic pain or uterine prolapse.
  • Severe abnormal uterine bleeding.

Types of Total Laparoscopic Hysterectomy

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Total Laparoscopic Hysterectomy (TLH)
  • Uterus and cervix removed.
  • Procedure performed entirely laparoscopically.
  • Small incisions in the abdomen.
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Laparoscopic-Assisted Vaginal Hysterectomy (LAVH)
  • Combines laparoscopy and vaginal surgery.
  • Uterus and cervix removed through the vagina.
  • Minimally invasive approach.
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Laparoscopic Supracervical Hysterectomy (LSH)
  • Partial removal of the uterus.
  • Cervix is preserved.
  • Less invasive, faster recovery.
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Robot-Assisted Laparoscopic Hysterectomy
  • Uses robotic technology for precision.
  • Often performed for complex cases.
  • Smaller incisions, faster recovery.

Symptoms Indicating the Need for TLH

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Heavy or Prolonged Menstrual Bleeding

Menorrhagia (heavy bleeding) or irregular periods.

Causes anemia and fatigue.

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Chronic Pelvic Pain

Persistent pain in the lower abdomen.

Associated with endometriosis or fibroids.

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Uterine Fibroids

Benign tumors causing pain, pressure, or bleeding.

May lead to infertility or complications.

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Endometriosis Symptoms

Severe pelvic pain, heavy periods.

Pain during intercourse or bowel movements.

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Uterine Prolapse

Dropping of the uterus into the vaginal canal.

Causes discomfort and urinary issues.

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Gynecological Cancers

Uterine, ovarian, or cervical cancer.

Hysterectomy part of cancer treatment.

Risk Factors for TLH

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How to Prevent TLH?

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Healthy Diet and Lifestyle

Low-fat, high-fiber diet reduces the risk of uterine fibroids.

Regular exercise improves reproductive health.

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Manage Hormonal Balance

Regular gynecological check-ups.

Hormonal therapy for fibroid management.

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Treat Infections Promptly

Early treatment of PID or STIs.

Prevents chronic pelvic inflammation.

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Medications

Birth control pills or hormone therapy.

Helps manage endometriosis symptoms.

Treatment Through TLH

Uterine and Cervical Removal

Complete removal of the uterus and cervix.

Treats various gynecological conditions.

Tissue Biopsy

Examination of removed tissues.

Detects cancer or other conditions.

Management of Fibroids or Endometriosis

TLH removes fibroids or affected tissues.

Provides long-term relief.

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TLH Procedure Steps

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Pre-operative tests:

Blood tests, ultrasound, and imaging scans.

Bowel preparation:

Laxatives or enemas for a clear bowel.

Medication management:

Stop blood thinners temporarily.

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Step 1:

Patient under general anesthesia.

Small incisions made in the abdomen.

Step 2:

Laparoscope inserted through an incision.

Provides a real-time image of the internal organs.

Step 3:

Surgical instruments inserted through other incisions.

Uterus and cervix detached from surrounding tissues.

Step 4:

Uterus and cervix removed through a small incision.

Closure of incisions with stitches or surgical glue.

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Recovery

Hospital stay of 1-2 days.

Full recovery takes 4-6 weeks.

Medications

Pain relief medications prescribed.

Antibiotics to prevent infection.

Follow-Up

Regular follow-ups to monitor healing and complications.

No heavy lifting or strenuous activities.