- TLH: Total laparoscopic hysterectomy
- LSH: Laparoscopic supra-cervical hysterectomy
- LAVH: Laparoscopic assisted vaginal hysterectomy
Hysterectomy is a surgery to remove the uterus and cervix. At the time of the hysterectomy, it is up to
the woman to make a decision of whether to have her ovaries and tubes removed. It is also possible to leave
the cervix. All of these options will be explained to patients in detail by the physicians so that a woman
can make a decision that is right for her.
The reasons for a hysterectomy are numerous and include problems such as symptomatic enlarged fibroids,
endometriosis, bleeding, and pain. Obviously, this is only a choice for women who do not desire to have
any children in the future.
Reno Gynecology offers minimally invasive hysterectomies. This means that the hysterectomy can be performed
with tiny incisions. The advantage of this is that the recovery time is minimal. Women go home the same day
or the next day from the surgery center. Patients also can return to work in one to two weeks. Unfortunately
the most common hysterectomy performed in the United States is the total abdominal hysterectomy. The physicians
at Reno Gynecology are highly skilled to perform the latest techniques to give patients the best possible outcome.
Reno Gynecology offers minimally invasive hysterectomies that can be performed in several different ways.
Complete laparascopic hysterectomies can be performed either with the da Vinci robot or with regular laparoscopy.
Again, with these surgeries, the entire hysterectomy is performed with tiny incisions. The doctors will discuss
these options as the decision of which type of surgery to be performed is based on the individual patient’s problem.
Another minimally invasive hysterectomy option is the laparascopic assisted vaginal hysterectomy (LAVH). With this
surgery most of the hysterectomy is performed with laparoscopy and the remainder of the surgery is done vaginally.
Another option for hysterectomy is a complete laparascopic supracervical hysterectomy. This is where the uterus
is removed but the cervix is not. The uterus is removed in small pieces through a half-inch skin incision and the
surgery is all performed with the laparascope. This surgery has an excellent recovery similar to the LAVH. Down sides
include the possibility of having to go back and remove the cervix because of pain, bleeding, or prolapse
A total abdominal hysterectomy (TAH) is where the uterus is removed through a skin incision in the abdomen. This can
be a low horizontal incision as in a Cesarean section or a vertical incision from the pubic bone towards the belly button.
Most are done through a low horizontal incision. The reason to do an open hysterectomy is when the surgery cannot be done
safely laparascopically. The most common reason is a uterus that is too large and extends near or beyond the belly button.
Other reasons would include severe scar tissue or cancer. This requires a two to three day stay in the hospital. Patients
can return to work in six weeks.
Risks of a hysterectomy include the risks of anesthesia; risks of damage to bowel, bladder, ureter, and other organs;
risk of infection; risk of hemmorhage and blood tranfusion; risks of nerve damage; and blood clots. Risks are higher in
patients with prior abdominal or pelvic surgery or history of endometriosis or scar tissue.
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