TLH: Total Laparoscopic vs Total Abdominal Hysterectomy

I am scheduled for a TLH on June 18th, 2015 due to abnormal uterine bleeding (periods are very heavy since having tubal in August of 2013. I will be having my cervix, uterus, fallopian tubes, and appendix removed with keeping both ovaries. I have been doing extensive research and would prefer to do total abdominal instead. What do you think my chances are that my Dr will respect my wishes? I have even researched him (had him for last 2 deliveries) and he specializes in hysterectomies and has been in his field for 33+ years. I go for my pre-op appointment with him on June 5th and am hoping he will give me the option of having an abdominal hysterectomy instead of laparoscopic.

Hi Nweiler,

I hope you are able to have your surgery done the way you are hoping for.
May I ask why you are hoping for an abdominal surgery rather than a Laparoscopic surgery?

Through my research I have been doing I have read that with a TLH there are higher chances of damaging other organs and with a TAH everything is open and visible making it less likely for damage to happen to other organs. A TLH is also more time on the table vs a TAH. Another bit of information. That has come to my attention is the cost between the 2 surgeries. A TLH costs more than a TAH. I am well aware that a TAH calls for a longer recovery time and more discomfort, but I would rather take that chance than to worry that other organs of mine could sustain possible damage.

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Originally Posted by nweiler27 Through my research I have been doing I have read that with a TLH there are higher chances of damaging other organs and with a TAH everything is open and visible making it less likely for damage to happen to other organs. A TLH is also more time on the table vs a TAH. Another bit of information. That has come to my attention is the cost between the 2 surgeries. A TLH costs more than a TAH. I am well aware that a TAH calls for a longer recovery time and more discomfort, but I would rather take that chance than to worry that other organs of mine could sustain possible damage.

That is really interesting information. I had the choice between doing a TLH or vaginally. I chose vaginally because I needed a posterior repair and my surgeon said if he did it vaginally he wouldn't have to use mesh. That was all I needed to make my decision. I was never given the option of doing it TAH but probably would not have chose it at that time based on the scar and recovery time. However, I did not have all the info from your research.

Totally understandable. I personally don't care about scarring and I don't wear bikinis or anything that would show my stomach so no worries there haha. To me, it can't be any worse than the stretch marks my children have left me with lol. I had asked my Dr in the beginning if he would just take everything so I don't have to worry about any cancers in the future, but he refuses to take my ovaries unless something is really wrong with them bc it can cause medical issues down the road. So I am happy to say I will be keeping my ovaries I'm just really hoping he will give me the choice of having a TAH vs a TLH.

I absolutely believe that you should have the last word on how the surgery proceeds! I sincerely hope that the dr respects your wishes. Let us know what happens. 😊

If the cost of the surgery is a concern, be aware that abdominal surgery usually comes with a longer hospital stay than laparoscopic surgery. I was in for three days, myself. You should factor that into your cost analysis.

I had a TAH myself, by the way, and my recovery was quite easy, with minimal pain and no complications. I was back to work at a part-time desk job at four weeks. Life was pretty much back to normal at eight weeks. :-)

I hope your doctor performs the surgery YOU want. You might want to ask him how many abdominal surgeries he's performed vs. other types. Since he specializes in the field and has been in it so long, my guess is that he probably has lots of experience with all types -- abdominal surgeries were much more common back in the day so I'd assume he's done plenty of those.

I had an abdominal surgery, but didn't have a choice due to the size of my uterus. Although, my doctor gave me the option of DaVinci, but she wouldn't have done it, she would've referred me to someone else. Like you, I'm not trying to be the next bikini model, lol, so a scar didn't concern me (I already have stretch marks, I'm not prancing around the beach in a thong, lol). My scar is a bikini cut, about 6 inches, and doesn't bother me. I had an easy recovery as well.

Best of luck!

Haha I have plenty of stretch marks. I haven't worn a bikini since I was 8 months pregnant (felt comfortable showing my prego belly vs my chub when not pregnant lol). I see scars as making someone a warrior in a sense.