Laparoscopic Supracervical Hysterectomy LSH

 

What is LSH?

It is the partial removal of the uterus and fibroids with preservation of the cervix along with tubes and ovaries if desired.

Why preserve the cervix?

By saving the cervix with its mucous secreting glands and its intricate nerve system many experts feel that sexual function is preserved.
The cervix and the ligaments that attach it to the body are crucial in preserving the integrity of the pelvic floor. By leaving that area intact there is a reduction in the incidence of bladder problems (incontinence) as well as prolapse of the vagina in later years.
Because of the use of the laparoscope adhesion formation is reduced so is pain after the procedure.

 

Description of the procedure.

Equipment used
          LSH is performed through advanced laparoscopy. Keyhole incisions are done
In the umbilicus (belly button) and 2 in the lower abdomen. Recently it can also be performed through only one umbilical incision. (SINGLE PORT ACCESS)
 
Using the latest technologic advances with modified electric cautery and coagulators or sonic waves
The uterus is separated from the ovaries and its attaching ligaments.
The body of the uterus is then separated from the cervix.
Fibroids and the separated uterus are them removed from the belly using a
Morcellator.

Watch a reduced edited video of Dr Yacoub performing a Laparoscopic Supracervical Hysterectomy ,

 

 This instrument cleverly cuts the uterus into small long pieces that are then
Removed through the small incisions made at the onset of the procedure. Ovaries and tubes could be removed the same way if needed.
The inner lining of the cervix is then cauterized to minimize bleeding from the cervix at
A later stage.
Sutures could be placed if needed and once the surgeon is sure that there is no bleeding the instruments are removed and the incisions closed with stitches or Dermabond.

Who is a candidate?

Most patients who are candidates to have a hysterectomy are also candidates for LSH
Except in the following situations.

          Presence or suspicion of cancer.
          Very large uterus that makes the morcellation process very tedious and long
          Extensive adhesions
          Abnormal pap smears

COMPLICATIONS AND RISKS:

Like any surgical procedure LSH is associated with risks of bleeding infection and
Trauma to organs in operative fields.
When compared to Total abdominal hysterectomy risks are reduced
Because the cervix is left in place, some patients may continue to have some form of spotting at the time of their cycles.

 
POSTOPERATIVE CARE

Hospital stay
Depending on the extent of your surgery you may be discharged home the same evening or the next day usually within 23 hours of your admission
Post op care:  Because of the minimally invasive aspect of this procedure pain is significantly less than when an incision is made .Average recovery is 6 to 14days.