Laparoscopic hysterectomy removes the uterus through tiny incisions in the abdomen. It is also called keyhole surgery because the uterus is removed through very small 1-2 cm incisions. Surgery to remove the uterus in Istanbul

There are different types of hysterectomy.

1. Total or subtotal (i.e. sometimes the uterus is completely removed and sometimes part of the uterus (cervix) is left in place).
2. Ovaries may or may not be removed (the ovaries may or may not be removed at the same time as the uterus. You should discuss this with your doctor)

 

 

 

Why and for whom is laparoscopic hysterectomy recommended?

• If you have excessive bleeding and drug treatment does not work
• If you have severe pain
• If you have a chocolate cyst and your symptoms do not improve with medication
• If you have fibroids
• If you have uterine cancer

 

What are the advantages of laparoscopic hysterectomy?

Because there is no incision in the abdomen;

• The hospital stay is short (the patient can get up quickly after the operation)
• The patient can resume her normal life within 2-3 weeks
• Less blood loss
• Very little surgical scarring
• Wound infections and wound dehiscence are less frequent. Surgery to remove the uterus in Istanbul

 

 

 

What are the alternatives?

There are different types of hysterectomy.

• Robotic
• Vaginal (a related article is on my website) (completely scarless, preferable if possible, requires experience).
• Abdominal

 

Ask your doctor about these options and discuss them along with laparoscopic hysterectomy. Please see the abdominal and laparoscopic hysterectomy images below. The abdominal technique is shown on the left and the laparoscopic technique is shown on the right.

 

 

What is done before the operation?

You will be thoroughly examined before the operation. In particular, your medical history, medication intake, smoking habits, etc. are asked. Some blood tests, chest X-rays and an ECG are performed. You will also be examined by the anesthesiologist.

What happens on the day of the surgery?

• You should not eat or drink anything until 8 hours before the surgery.
• It is advisable to take a shower the night before the surgery.
• Take off your jewelry and leave it at home. If you cannot take it off, inform your doctor.
• Remove any nail polish or artificial nails.
• Take any medications you are taking with you to the hospital.
• When you are admitted to the hospital, the nurse will examine you (temperature, pulse, blood pressure). You will then be given a surgical gown and an ID bracelet will be placed around your arm.
• You should also remove makeup, dentures, glasses and contact lenses, if you have them.
• The surgeon will then see you and explain the procedure again. If you have not yet signed the consent form, the surgeon will ask you and your family to sign it.
• The anesthesia team will also see you and explain the anesthesia technique. You will need to inform the anesthesia team of any allergies, dental problems, or anesthesia experiences in your family.

 

How long does the operation take?

Laparoscopic hysterectomy takes 2-3 hours depending on the patient. However, some time is spent in the recovery room after the procedure.

 

What happens after the operation?

• After the surgery, you will be taken to the recovery room where, once you are fully awake and your general condition has improved, you will be transferred to your bed in the clinic.
• Because the surgery is performed under general anesthesia, you may feel tired and sleepy for the first 24 hours. During this time, you will receive pain medication.
• You will also receive intravenous fluids and nutritional therapy. During this time, you will have a urinary catheter placed so that you cannot go to the bathroom by yourself. In some patients, a tube called a “drain” is placed but on the abdomen. These will be removed the next day.
• The nurses will tell you when you can eat and drink. In the beginning, it is recommended to drink water, warm tea, or soup. Later, plenty of water will be helpful. Over time, your appetite will return, and you can eat different things you like.
• One of the most common side effects of laparoscopic hysterectomy is “shoulder and abdominal pain.” This pain and discomfort may last for a few days. It is a good idea to take the pain medication you received at discharge regularly for 1-2 days.
• Most patients are discharged 24 hours after surgery. In some cases, this period may be longer.
• Because the bowel works slowly due to the surgery, gas may build up. This may cause you discomfort or pain. Therefore, you should get out of bed as soon as possible and move around a lot. Passing gas is a sign of improved bowel function.
• You will have 3-5 tiny (0.5-2 cm) incisions on your abdomen that will be covered with mini bandages. Stitches will also be placed in the vagina, but they will not be visible from the outside and will dissolve on their own. The bandages on your abdomen will be removed the next day, and you will be able to shower (your doctor will tell you about showering depending on the condition of the stitches). You do not need to worry about your stitches (wounds) getting wet. However, if they do get wet, you should dry them with clean napkins or air them and keep them dry. When sutures are dry and clean, they heal faster and fewer wound infections occur.
• You should avoid sexual activity before 6 weeks.
• Wash your hands before and after you use the restroom. Also wash your hands before and after you touch the wound sites.
• You may experience light vaginal bleeding for up to 1-2 weeks after surgery. During this time, you should use pads and not tampons.

 

Remember, post-operative recovery is a personal experience.

 

What can I do to recover faster after a laparoscopic hysterectomy?

• Give yourself plenty of rest and relaxation for the first few days. However, make sure to be active. You can do light chores around the house for the first few days. It is okay to climb the stairs the first day you get home from the hospital. Gradually increase your activity each day.
• Be sure to eat a balanced diet and get the nutrients you need. A healthy diet high in fiber and 2 liters of fluids (mainly water) per day are recommended.
• Try to quit smoking. Smoking delays wound healing.

 

When should I go for check-up?

Your doctor will inform you, but usually the first checkup is between 3 and 6 weeks. The pathology result will also be monitored by your doctor and you will be informed. You can remind your doctor about the pathology result in the postoperative period.

 

What can delay your recovery?

• A possible complication during the operation
• Additional diseases that existed before the operation (e.g. diabetes)
• Smoking
• Excess weight
• Sometimes we need to enlarge the incisions during laparoscopic surgery or even return to open surgery. In this case, your hospital stay may be longer and your recovery may take 2-3 months.

 

What are the complications of laparoscopic hysterectomy?

From time to time, situations arise during surgery that we do not want. Any surgical procedure carries some risk.

• Bleeding (the rate of bleeding requiring blood transfusion is 1-3%)
• Vaginal Hematoma (a thick pool of blood may form in the vagina): In most cases, it regresses spontaneously. Very rarely, antibiotics or a new operation are required.
• Infection: 10% (in the lungs, urine, wound site, groin)
• Blood clotting (in the lungs or leg, less than 1/100): It occurs less frequently in active people who drink a lot of water. In addition, anticoagulants are used at discharge.
• Damage to the intestine (2%)
• Damage to the urinary bladder (1%)
• Damage to the ureter (urinary canal) (1%)
• Vascular and nerve damage (< 1%)
• Need for repeat surgery: there are patients who need to undergo a second surgery requiring an abdominal incision due to bleeding or other complications (1%)
• Intraoperative conversion from closed to laparoscopic technique (1-25%)

What are the emergencies after surgery?

• Redness and swelling at the wound sites
• Burning during urination
• Heavy bleeding from the vagina
• Swelling in the leg
• Shortness of breath
• Pain in the chest
• Severe abdominal pain
• Loss of appetite and vomiting
• High fever