LSH

* * * admin note * * * These replies were split from this thread https://www.hystersisters.com/vb2/sho...hreadid=124816 as they had developed into a subtopic which got away from the original question

Hello!

I notice Lady Ophelias post and was somewaht compelled to reply. While she is basically correct with regard to the type of procedures she mentioned, she did neglect to tell you about the LSH (laparoscopic supracervical hysterectomy). While this procedure is not widely used at this time, it is something you might want to ask your phsyician about.

With the LSH you hysterectomy is performed completely via a laparoscopic procedure. There is one incision into your belly button, and then one 1" incision on either side of your lower abdomen for a total of 3 extremely small sites that a either sutured or glued shut. The recovery time varies from person to person, and also on following the directions given by your physician.

In my case I did have the surgery on a Firday morning and was released from the hospital the next morning. I was up within 6 hours post op and feel that this was due to the adminstration of a shot of long acting morphine to my spine immediately before being put under. Yes, I was my normal self by Monday (day 3) and was out shopping, and returned back to work by day 10. Is this unusual, NO! For this procedure it is the type of recovery one can expect. Be aware that I did follow my physicains advise, walk/stroll a lot, no lifting over 5 lbs, rest when your body tells you to.

While this is not the typical recovery for the more invasive procedures ophelia listed, we should all remember that we all respond differently to the anesthesia, pain, etc. so someone might feel fine in 5 days and someone might not.

No one can tell you how long it will take to recover, but as long as you follow your physicians directions to the "T" your body will heal at it's own rate, only used our tales as a guide, and do not feel that there is something wrong should you heal faster or slower.

What is so great about everyone on this site is that each individuals exerience has been different therefore we can all offer knowledge on the different procedure, recoveries, as well as the advantages and disadvantages to the different procedures.

GOOD LUCK!!

I agree with ANNIE918. Each persons recovery is different based on the type of surgery they have. It also depends on other factors such as your own personal physical condition and mental attitude. The laparascopic procedures are less invasive and usally only require one night in the hospital and 2 - 3 weeks recovery time. Some dont require any stitches. It offers a much shorter recovery time. Obviously any surgery can develop complications but thats rare. You just dont see many posts from women who had the best experiences because they are no longer in need of support or advice and they have moved on. As you can see by the many posts and by comparing procedures you will notice the obvious differences. Laparascopic hysterectomies have been practiced since 1988. They really arent new at all. They just havent been so popular because the Doctors in training at that time were in residency with others who were committed to the traditional methods. As time went on and they stepped into their own practices they ran into the problems of expensive disposable surgical tools and Trandelenberg tables that most hospitals didnt have and insurance companies wouldnt reimburse for the costs for them. Now , today, other laparascopic surgeries such as gall bladder and gastric bypass are increasingly popular the insurance companies and hospitals are better equipped and see the cost effectiveness in the speedier recoveries and less hospital stay requirements. These days the laparascopic hysterectomy is growing in popularity with a vengence as you will see on this message board as well as others.

Okay...I feel a little bit jumped on right now so let me clear things up a little.

I did not put the LSH into my post because of a few reasons. The fact that it's new (1988 still makes it "newish") and there are still a lot of doctors that do not do them. I know my doctor does do it, but it's based on a patient to patient basis. Each procedure has a set of guidelines to meet. The only one that I met was the TAH because of endo as well as my doctor wondering if I needed some bladder work. Therefore LSH wasn't averaged in to the healing time that is "normally" set up.

Yes!! Each woman heals at a different rate. I'm not saying that it's all bull kaka, but for "some woman" it takes 4-8 weeks to heal and recover and up to a full year to get her energy back to where it was before surgery.

Also, no matter what surgery you have you do have internal stitches. Those take time to heal. That's why you see the "initial healing time is 4-6 weeks." It takes time for stitches to desolve as well as nerve endings (more so with a TAH) to fire back up and mend themselves. That's why following those doctor's instructions to a "T" is so very important.

A lot has to do with positive attitudes, loving family, help when you need it.

As far as my recovery. I had a TAH and was out of bed within a few hours after surgery and home within 24 hours. No cathader, no pain meds pump (however, I was hooked up to an IV for possible dehydration because it had been so long since I drank). Was my recovery odd for a TAH? Of course it was. Just by reading posts here I know that I'm not in the "norm" for a TAH, but it was my attitude that got me going. I also didn't have the dreaded constipation for more then two days and gas for about 4 days I think.

I would never presume to tell you that "this is the way it is," but this is the way it is for "some women."

Hmmm...I'm feeling a little sensitive right now. Lack of sleep will do that to a person.

LadyOphelia:

Our only point was that everyone heals at a different rate and that the Laparascopic surgeries are far more quicker in recovery time. SOME women have been back to work after a week depending on the type of job they have, if they work out of their homes, desk job, part time, etc. I was back to work after 26 days lifting 100 pounds with no difficulty and no more restrictions.

By the way,,,,for future reference.....NOT ALL hysterectomies have internal incisions. I am speaking from personal experience. Thats the difference between less invasive laparascopic procedures that enables a faster recovery and others that require large incisions and manipulation internally.

We're not jumping on you. We're just speaking from experience that it wasnt as bad for Laparascopic patients as you were letting on. We speak from experience on that procedure just as you speak for your own. Please dont take it personally.

It was a lack of sleep problem. I was being overly sensitive (even my poor family noticed ). That is normally not me though.

I remember asking my doctor about a LSH. He said "yes I do them, but no you can't have one." He had done my tubal (laparascopic) and knew what he was in for.

Now I do have a silly question. Well, it's not a "silly" question, but since I didn't delve into the LSH because I couldn't have it, how exactly does the uterus get out and what do you lose? Do you keep the cervix or is it up to the doctor on that one?

Ophelia;

They use a took called a mortucilator. Not to be gross, but this tool basically peels the uterus, ovaries, tubes and they comeout in a long strip and are sent to pathology. The LSH would not be used if someone were to have an extremely enlarged uterus, or major fibroids, or the possibility for cancer since cutting the organs could release the cancer cells into the abdominal cavity where they could seed and grow.

Now, I had a slightly enlarged uterus (even after 6 mo of Lupron), severe adhesions, and endo, but the doc was able to cmoplete the LSH as planned. About 5% of people who are admitted for the LSH wind up with a TVH or TAH due to unexpected complications.

Did you doc give a reason why you were not a candidate?? I was just wondering because there seem to be so few people around that have had this procedure done.

Annie

Hi Annie

He didn't give a lot of explaination, but what he did say was that because of my endo (he tied my tubes 6 1/2 months prior) and the fact we didn't exactly know how my grandma passed away (they thought they have gotten the mass when she had a hyst, but it ended up being a mass behind the uterus and they completely missed it). He thought it was best to do the TAH (with a bikini but) to get a better view of everything. He says that he can get a good view with the bikini cut and prefered that over the vertical because there's a harder time of healing and he was pretty sure there was nothing unusual when he went in just by viewing the ultrasound. My uterus was fairly normal size I think. Looks like normal is around 80 grams and mine was 98 grams. The cervix had to go too. Too much damage from 6 pregnancies.

Oh, that would explain it!

I was not a candidate for TVH since I have had no children, which wound up being in my favor for the LSH, besides, I we left my cervix.

I just got my op report and honestly I am suprised that my gyn did not bail and do a TAH when he took a look and saw how bad the endo and adhesions were.

It will be interesting to see how the use of the LSH progresses in the next few years because we only have a few docs in my area that are able to do this procedure.

Annie

Hi Annie

The doctor said (when I had my tubal) that I had a mess inside. Probably safer for me to just go with the TAH. DH was able to be home for two weeks and then the kids were home for that last week to help out. He was very honest and said at my post-op for my tubal that if the pain came back at all I had two choices. Surgical menopause or medicine menopause. He knew that I didn't want to pop anything in my body.

LSH is such a wonderful thing. I hope that my girls (two girls, two boys) don't have to go through this ever, but I'm happy that they could have a chance to get a less invasive procedure. I shudder to think that my 10 year old daughter has a double whammy with this. She hasn't started her period yet, but her aunt (on DH's side) and now myself have had hysters. My grandmother had one and my mom should have, but never did. What is going to happen to her?

Well...in my case....I didnt not have my ligaments reattached to anything. Three internal incisions were made.....to cut each tube from my uterus (2) and to remove my uterus from my cervix (1). The scapel is not your standard scalpel. Its a Harmonic scalpel that cauterizes and coagulates as it separates the uterus from the its surrounding membrane that holds it in its position in my abdomen. Nothing else was cut around it. I specifically asked my surgeon if I had stitches or anything repositioned or if she cut through any ligaments or tendons and she said ""NO"". The Laparascopic tools used are strategically inserted in places that do not penetrate ligaments or muscle. She did not manipulate my internal organs other than to gently inspect them. I even went as far as to ask her how she sealed off my cervix without stitches and she said by using a surgical mesh. I asked how she attached the surgical mesh and she said it forms a gel-like barrier and adheres on its own and would also prevent adhesions. But still....at my amazement, she confirmed....NO stiches internally, I could SEE that I didnt have any stitches externally and no tendons or ligaments were cut or repositioned. I was cleared to regular activities with no restrictions after two weeks and I was lifting 100 pounds repetitively throughout my workday 26 days later with no pain.

So I dont know what more to tell you. I was there. I asked the questions. I went through the procedure. I cant be the only one in the world, can I??