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What is laparoscopic supracervical hysterectomy?
Laparoscopic supracervical hysterectomy is a partial hysterectomy, in which the surgeon removes only the diseased uterus and preserves the cervix and ovaries.
A laparoscope is a thin tube with an attached telescope and a light source, which is used to light up and view the inside of the pelvic structure and the abdomen. It allows the doctor to examine the inside clearly and find the cause of symptoms such as abdominal pain, pelvic pain, or swelling of the abdomen or pelvic region.
Laparoscopic supracervical hysterectomy causes less vaginal dryness, (which is a common complaint after other modes of hysterectomy), as the glands of the cervix continue to secrete mucus. This method also provides better pelvic support, because the ligaments that support the cervix and vagina are left intact by the surgeon.
Depending on the patient’s condition, the surgery can take anywhere from 60 minutes to 90 minutes.
How is laparoscopic supracervical hysterectomy performed?
Laparoscopic supracervical hysterectomy procedure involves the following steps:
- At the outset, the anesthetist administers depending on your overall health condition.
- Once the anesthesia takes effect, the doctor makes an incision (approximately 1 inch) right at the top of the vagina.
- He inserts a laparoscope (miniature camera) through a small abdominal incision to view the uterus and surrounding organs.
- Using fine instruments, he detaches the uterus from the cervix and removes it through one of the abdominal incisions.
- He then sutures the incisions and dresses them. The dressing needs to stay in place for a week.
Am I eligible for a laparoscopic supracervical hysterectomy?
You are eligible for a laparoscopic supracervical hysterectomy if you suffer from:
- Cancerous tumor within the uterus
- Large fibroids
- Chronic and excessive bleeding (menorrhagia)
- Uterine prolapse
- Endometriosis
- Adenomyosis (thickening of the uterus)
- Chronic uterine infection
- Severe pain associated with menopause
Please Note: Eligibility criteria for various medical procedures differs from patient to patient and depends on their general health, medical history, and medical conditions. Please consult a doctor to know more about your eligibility or ineligibility for any medical procedure.
What risks will I face while undergoing and after the laparoscopic supracervical hysterectomy procedure?
After undergoing a laparoscopic supracervical hysterectomy the patient may suffer from:
- Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum.
- Infections
- Sepsis
- Pain
- Excessive bleeding (the risk of this is higher in women who are obese or who suffer from diabetes/high blood pressure)
What are the disadvantages of laparoscopic supracervical hysterectomy?
The disadvantages of laparoscopic supracervical hysterectomy may include:
- If the doctor is unable to remove a very large uterus or areas of endometriosis, adenomyosis, or scar tissue (adhesions), he may have to switch to abdominal surgery.
- This procedure consumes more time.
- If it is an inexperienced surgeon, there is a higher risk of injury such as intestinal injury, urinary tract injury, ureteral injury etc.
What are the complications of laparoscopic supracervical hysterectomy?
The complications of laparoscopic supracervical hysterectomy may include:
- Pelvic abscess
- Peritonitis (inflammation of the peritoneum, the thin layer of tissue covering the inside of your abdomen and most of its organs.)
- Heart palpitations
- Myocardial infarction (or heart attack especially in older patients)
- Inadvertently created fistula during surgery, which can cause urinary incontinence or urinary leakage
- Stress urinary incontinence
- Intestinal injury
- Urinary tract injury
- Ureteral injury
- Bladder injury
- Abdominal wall injury
- Vascular injury or injury to major blood vessels
What are the side effects of undergoing a laparoscopic supracervical hysterectomy?
The side effects of laparoscopic supracervical hysterectomy may include:
- Early onset of menopause
- Loss of sexual desire (conversely some women experience a drastic improvement in their sex life)
- Pain during sexual intercourse
- Occasional spotting or pink discharge for up to about 6 weeks.
How will I benefit from undergoing a laparoscopic supracervical hysterectomy procedure?
The benefits of undergoing laparoscopic supracervical hysterectomy may include:
- A shorter stay in the hospital and less recovery time compared to traditional hysterectomies because of the small incisions used in the laparoscopic approach.
- Less pain during recovery
- Smaller scars on the abdomen compared to longer scar caused during abdominal hysterectomy
- In this mode of hysterectomy sparing the ovaries in most cases avoids the need for hormone replacement.
What are my alternatives to laparoscopic supracervical hysterectomy?
The alternatives to laparoscopic supracervical hysterectomy include:
- Medical/hormonal management
- Hysteroscopy
- Laparoscopic myomectomy
- Endometrial ablation
- MRI-guided focused ultrasound (MRgFUS)
- Uterine artery embolization (UAE)
- Abdominal hysterectomy
- Vaginal hysterectomy
What are the pre-procedure guidelines I should follow for a laparoscopic supracervical hysterectomy?
Preparation for a laparoscopic supracervical hysterectomy typically involves several steps:
- Physical examination to determine the overall health condition
- Pelvic exam
- Blood and urine tests
- Complete medical history discussion with your surgeon
- If you smoke, you will be advised to quit smoking, for at least 6 weeks prior to the surgery since smoking can delay the healing process
- You will be advised to not drink and eat anything at least 12 hours prior to the procedure.
- Your doctor may prescribe an enema or a laxative to empty your bowels thoroughly before the surgery
- The doctor may prescribe some medicines prior to the surgery which can reduce the risk of heavy bleeding during the surgery
- You need to inform the doctor about any over-the-counter medications, prescribed medicines, dietary supplements or herbal preparations that you're taking.
What are post-operative guidelines I need to follow after undergoing a laparoscopic supracervical hysterectomy procedure?
Some of the post-operative guidelines following a laparoscopic supracervical hysterectomy are:
- Overnight stay in the hospital for 1 to 2 days. You will be monitored for discomfort and given medications to prevent pain and infection and promote healing.
- Post the surgery you should avoid lifting heavy weights or any form of strenuous physical activity for at least upto 6 weeks.
- You need to avoid tub baths for at least 6 weeks after the surgery.
- You may have to take a liquid diet temporarily.
- During the procedure, a catheter is attached through which you will be passing urine. It will be removed the day after surgery.
- Your incision will be covered with either surgical dressing or glue.
- You will need to use sanitary napkins since vaginal bleeding may occur after a hysterectomy procedure and may last for a few weeks.
- During the first week post the surgery you should not be standing on your feet for more than 30 minutes at a time.
- After any surgery, constipation is a common problem due to the number of medicines and inactivity. Eating fruits and vegetables and drinking lots of fluids may help you avoid constipation. And if that is not helpful, or if constipation worsens, the doctor may prescribe a stool softener or a laxative.
What is the recovery period after undergoing a laparoscopic supracervical hysterectomy procedure?
The recovery period after undergoing a laparoscopic supracervical hysterectomy is usually 6 days – 2 weeks depending on overall health conditions.
Are the results of laparoscopic supracervical hysterectomy permanent?
There is no definite answer to this question, as the results of the surgery can vary from person to person. Some people may experience complete relief from their symptoms, while others may suffer from slight side-effects. It will be wise to discuss your complete medical history with the doctor and also get to know the risks involved for you personally before taking a decision to undergo the procedure.
How do I know if the laparoscopic supracervical hysterectomy procedure I underwent is a success?
Here again, the results vary from person to person. Ideally, if you are free from the earlier painful and discomforting symptoms, then quite obviously, the procedure has been a success for you. If you experience side effects after the procedure for prolonged periods, then you may need to consult with your doctor once again to understand the situation and opt for further treatments.
More Hysterectomy Related Topics
People interested in this topic also read:
Hysterectomy Procedures: Types, Costs, & Risks
Types of Hysterectomy
Methods/Techniques of Hysterectomy
Related Topic
Endometriosis: Symptoms, and Treatment
In the Spotlight- Latest News on Hysterectomy
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References
1. Odejinmi F, Oliver R. Laparoscopic Supracervical Hysterectomy for Large Uteri. 2018. Available at: https://link.springer.com/chapter/10.1007/978-3-319-22497-8_33. Accessed February 27, 2018.
2. Berner E, Qvigstad E, Myrvold A, Lieng M. Pelvic Pain and Patient Satisfaction After Laparoscopic Supracervical Hysterectomy: Prospective Trial. 2018. Available at: http://www.jmig.org/article/S1553-4650(13)01364-2/abstract. Accessed February 27, 2018.
3. McGurk L, Oliver R, Odejinmi F. Laparoscopic supracervical hysterectomy for the larger uterus (>500 g): a case series and literature review. 2018. Available at: https://link.springer.com/article/10.1007/s00404-016-4237-0. Accessed February 27, 2018.
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