Laparoscopic Hysterectomy

In this type of hysterectomy, a doctor inserts a thin, lighted telescope-like instrument called a laparoscope and other small surgical instruments into the navel and abdomen through 3 to 4 small incisions, each less than a quarter-inch long. The laparoscope acts like a video camera, guiding the surgeon as he or she carefully removes the uterus (womb) through one of the openings.

Because laparoscopic hysterectomy does not require the surgeon to make a large abdominal incision, it’s a less invasive procedure than traditional methods of hysterectomy.

In a laparoscopic hysterectomy, the cervix, the bottom part of the uterus, may be left intact.

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Benefits of keeping your cervix

In a laparoscopic supracervical hysterectomy (LSH), the surgeon leaves the cervix intact. The cervix connects the upper portion of the vagina to the uterus. The ligaments attached to the cervix provide support for both organs. For this reason, many gynecologists feel that leaving the cervix in place is important to maintain good pelvic floor support.

One of the most common pelvic floor support problems is pelvic organ prolapse, a condition in which organs in the pelvic region drop out of their normal position (prolapse). Prolapse can be uncomfortable both physically and emotionally, causing women to limit their movements because of pain, urinate more frequently and avoid sex.

In addition, some research suggests the cervix may play a role in sexual arousal and the ability to achieve orgasm in some women.

Keeping the cervix means you may still experience some periodic bleeding. Like women who have not had a hysterectomy, you should continue to have an annual Pap smear to screen for cervical cancer.

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Who is a candidate for a laparoscopic supracervical hysterectomy (LSH), in which the cervix is retained?

Most women are candidates for this procedure when considering a hysterectomy for nonmalignant diagnoses. Patients not generally considered optimal candidates for LSH are women with history of cervical dysplasia or endometriosis near the cervix. Additionally, if the uterus is very large due to fibroids, it may not be possible to perform this type of hysterectomy.