I've heard of the LSH type of hysterectomy and would like more info. Many have said it is the way to go because the recovery is so much easier. Are there complications associated with the laparoscopic hysterectomy?
The LSH is a relatively newer procedure in the world of hysterectomy.
DEFINITION
A LSH (Laparoscopic Supracervical Hysterectomy) is done completely laparoscopically and does not remove the cervix.
Possible Patient Candidate
Not everyone is a candidate for this method of hysterectomy. Not every doctor has the experience to perform this type of hysterectomy.
Women with a history of "bad pap smears" are generally not a good candidate for the LSH because this type of hysterectomy leaves the cervix in place.
Women with a history of excessive bleeding may not be a good candidate. Most doctors cauterize the cervix lining in an attempt to stop future mini-periods, in some cases this is temporary stop.
Women who are having their hysterectomy for the possible reason of cancer are generally not good candidates.
METHOD
The uterus is cut up into small pieces and removed through the tubes, which were inserted into the abdomen. Not all women are candidates for laparoscopic hysterectomies and the decision to use this method must be made on an individual basis. You should expect 2 to 4 weeks of recovery, with some lifting and straining restrictions that could extend beyond this period. You may have restrictions on sexual activity for this initial recovery phase.
It is also possible that your doctor will perform a Total Laparoscopic Hysterectomy. In this case, the surgery will still be performed entirely laparoscopically, but the cervix will be removed.
RECOVERY
Usually the 4-5 small incisions of a laparoscopic hysterectomy can be covered with Band-Aids. Although your incisions are small, internal healing must still take place. Be sure to rest enough so your body can heal properly.
POSSIBLE CONCERNS or COMPLICATIONS
Whether or not you have an abdominal incision with visible staples or stitches, with any type of hysterectomy you will have many (possibly hundreds of) internal stitches. It is this internal healing that can take anywhere from six months to a year to be complete.
If you strain yourself too soon, one of the most catastrophic things that can happen is that you can tear some of your stitches. This can result in bleeding, possibly even hemorrhaging. In a few cases this has required emergency surgery and blood transfusions.
The trouble is, some of the damage you might do can cause long term results, which are not possible to detect while you are doing it. When your tissues are healing they are very sensitive to being pulled and squeezed.
Scar tissue wants to form wherever there are internal incisions, and if there is even a tiny amount of bleeding inside it can cause areas to 'stick' together, with the result that bridges of scar tissue can form between organs or tissues that should not normally be connected.
During weeks 3-4 your incisions may be itchy and perhaps give you strange sensations ranging from numbness to tingles. Your swelly belly may be bothersome as well, looking fine in the morning but feeling achy and swollen by the evening.
HysterSisters having had LSH have reported these post-op concerns:
Mini periods that were not "mini"
Cervix developed dysplasia and needed to be removed later
Bowel nicked during surgery
Bladder nicked during surgery
Complications and Results of 361 Hysterectomies Performed at Laparoscopy, Farr Nezhat, MD, Ceana H. Nezhat, MD, Dahlia Admon, MD, Stephen Gordon, MD, & Camran Nezhat, MD; J. Am. Coll. Surg., 1995, 180:307-16
Before the appropriate use of laparoscopy in hysterectomy can be determined, it is necessary to evaluate the results, including complications. There must also be an accepted classification system to facilitate accurate comparison to total abdominal hysterectomy. We retrospectively evaluated the charts of 361 women who underwent hysterectomy for various benign pathologic condition. Intraoperative and postoperative complication rates for hysterectomy performed at operative laparoscopy were examined. The hysterectomies were classified as one of four types according to the number of steps performed laparoscopically. All women were candidates for total abdominal hysterectomy, but not vaginal hysterectomy. The overall complication rate for hysterectomy performed at operative laparoscopy was 11.1%. Most complications were minor, including cystitis (1.66 %), transient high fever (1.39%), abdominal wall ecchymosis (1.12 %), and pneumonia and bronchitis (1.12 %). There was no correlation between the type of laparoscopic hysterectomy performed and the complication rate. Our rate of intraoperative and postoperative complications associated with laparoscopic hysterectomy compares favorably with published complication rates for vaginal and abdominal hysterectomy.
This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.
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