LSH  -  LAPAROSCOPIC     SUPRACERVICAL

HYSTERECTOMY

or

ONE DAY HYSTERECTOMY

 

What is a Laparoscopic Supracervical Hysterectomy,  or LSH ?

 Dr. Kenneth Goodrich, M.D. was the first gynecologist in the area to perform the latest advanced hysterectomy technique, called a Laparoscopic Supracervical Hysterectomy ( LSH ). Using three small incisions he can remove the uterus, tubes and ovaries in most women. By leaving the cervix and vagina intact patients have less pain, less internal scarring, less risk of surgical complications, a faster recovery period, and often have greater sexual pleasure.  Most patients are able to go home on the same day of surgery or with only one night stay in the hospital. All patients are under general anesthesia for this surgery.   

     L S H is the least invasive manner to  perform a hysterectomy.  Dr. Goodrich uses key hole surgery, called laparoscopy, to remove the uterus through 3 small incisions.  Preserving the cervix is a key advantage for patients having this surgery. Patients have a reduced risk of damage to the bladder, less chance of prolapse of the bladder and vagina. This less invasive surgery also allows women to rapidly return to their normal sexual activity and gives many a feeling of wholeness that may otherwise be lost.  

                                LSH   Advantages

 

COMMON CONDITIONS REQUIRING

HYSTERECTOMY

 

ABNORMAL UTERINE BLEEDING

 

UTERINE  FIBROIDS

 

UTERINE  PROLAPSE

 

CHRONIC  BLADDER  LEAKING

 

PRE-CANCEROUS LESIONS OF THE UTERUS

 

CERVICAL CANCER

 

UTERINE CANCER

 

 

COMMON CAUSES OF

ABNORMAL VAGINAL BLEEDING

  

CERVICAL POLYPS

 

CERVICITIS—INFLAMMATION OF THE

CERVIX

 

CERVICAL CANCER OR PRE-CANCEROUS LESIONS OF THE CERVIX

 

FOREIGN BODIES IN THE VAGINA

 

OVARIAN CYSTS

 

OVARIAN CANCER

 

UTERINE INFECTIONS

 

UTERINE FIBROIDS

 

UTERINE POLYPS

 

UTERINE HYPERPLASIA

 

UTERINE CANCER

 

UTERINE CANCER

 

The Operation

You will have a general anesthetic and will be completely asleep. Incisions are made in the belly button and in the lower part of the stomach. These “keyhole” incisions will be very small. The uterus is taken out through these small incisions leaving the cervix. If the ovaries are diseased, they will need to be taken out as well. All tissue is sent to the laboratory to be examined under the microscope. You will be in hospital from 4 to 24 hours. If both ovaries are taken out, you may have menopausal problems such as hot flushes and dizzy spells. You can stop them by taking hormone replacement therapy (HRT). This can be started soon after surgery.

Any Alternatives

An alternate of hysterectomy is using keyhole surgery to free off the body of the uterus and cervix and bringing both out through the vagina. This procedure is called an LAVH – laparoscopically assisted vaginal hysterectomy. The hospital stay is a little longer and the recovery time is longer also, as noted in the table above. Rarely, the tummy has to be opened as for an abdominal hysterectomy. We rarely use this procedure unless bleeding, very large masses or cancer is present.

Before the operation

Stop smoking and get your weight down if you are overweight.  If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation. Sort out any tablets, medicines, inhalers that you are using. Keep them in their original boxes and packets. Bring them to hospital with you.

In the hospital, you may be checked for past illnesses and may have special tests, ready for the operation. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form. Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks.

After - In Hospital

You will have a small/thin plastic tube (a drip) in an arm vein. This gives you salt and sugar and water, and sometimes blood, for a day or so from a plastic bag on a stand. You may be given oxygen from a face mask for a few hours if you have had chest problems in the past.  You may have some backache. You may be given injections or tablets by the nurses for the pain.

By the end of two days you should have little pain. A general anesthetic will make you slow, clumsy and forgetful for about 24 hours. Do not make important decisions during that time. The nurses will help you with everything you need until you can do things for yourself. You will have some blood and urine tests in the first day after your operation. These will check you are not anemic and have no infection in the urine.

You may have a fine tube (catheter) in the bladder to drain it for a day or so after the operation. There will be slight bleeding like the end of a period.  Use pads. Do not use tampons for six weeks. If the bleeding is heavy, call the office.

You will be able to take a bath or shower as often as you wish. Do not soak in the bath for more than 10 minutes. Try to keep the wound area dry for a week. You will be given an appointment for an Out Patient check up about two weeks after you leave hospital. They will have the results of the tests.  

After - At Home

At home, you are likely to feel tired and need rest two or three times a day for one or more weeks. You will gradually improve. After three months, you should be able to return completely to your usual level of activity. You can drive as soon as you can make an emergency stop without discomfort, generally after one or two weeks. You will be able to start sexual relations before your six-week check, if you are comfortable and have no bleeding or discharge. You may be able to return to a light job after about one week.  

Possible Complications

As with any operation under general anesthetic there is a very small risk of complications related to your heart or you lungs. The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.

Most hysterectomies are without complication. Minor complications happen in up to 2% of cases. Chest infections may arise, particularly in smokers. Do not smoke. Occasionally the bladder is slow to start working again. This requires patience. You may need the catheter back in the bladder for a few days. Wound infection is sometimes seen. This settles down with antibiotics in a week or two. Aches and twinges may be felt in the wound for up to six months. Sometimes there are numb patches in the skin around the wound which get better after two to three months. Sometimes scarring in the vagina makes intercourse difficult or uncomfortable. This usually settles down with time.

More serious complications happen very rarely and can include severe bleeding or damage to your bladder, bowel and vessels and may require another operation to fix them.

General Advice

We hope these notes will help you through your operation. They are a general guide. They do not cover everything. If you have any queries or problems, please ask Dr. Goodrich or the nurses.

 

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                               KENNETH GOODRICH, M.D.  -  OBSTETRICIAN- GYNECOLOGIST  
     
                   Certified by the American Board of Obstetrics and Gynecology

     Specializing in General Obstetrics and Gynecology, Minimally Invasive Gynecological Surgery- Hysterectomies
              and Uterine Fibroids, HPV treatment for Women and Men, Surgery on Obese Women,  Chronic Vaginal
              Discharges, Sexually Transmiited Diseases, Menopause, Abnormal Bleeding ,Cellulite Reduction and
                                                      Aesthetic Services