TLH: Pre surgery clearance

I took my checklist questions with me yesterday. My doc pretty much answered all my questions before I even got my list out.
I did learn a few things that I didn't realize.
One being my uterus and cervix and fallopian tubes will come out vaginally. I thought laproscopically it was morcellated and taken out via the tubes they put in you. She assured me that she didn't think she would have any problems doing it laparoscopically but there was always the possibility of having to do an abdominal incision. Im not doing any bowel prep but I wish I were. She did say most complications arise with the bladder if it were nicked but she checks it thoroughly during surgery even doing a cystoscopy. I will have a catheter that will stay in until the following morning and if there are any problems with the bladder and I need a "sling" then catheter stays in for maybe a week. I have been doing my kegels! I also made sure she is the one doing the surgery. No 'trainee'. She also said they want me up walking around as soon as possible after surgery. Keeps down the blood clot chances. Im hoping I am able- I did get up and walk around right after I had my son but that was 22 years ago and I didn't have any meds on board.
I didn't have an exam- except for blood pressure and
listening to my heart.
I was worried about my last ultrasound (over a year ago) and asked if we needed to do another one. Doc put me at ease saying it probably hasn't changed much but she is going to take a good look around and even check my appendix and gallbladder. My gallbladder gives me issues if I eat a lot of fatty foods but garlic pills help with that. I haven't been taking them though because of the surgery.
But I am looking forward to surgery now and she put my fears at ease mostly.

You may want to look up information on LAVH - which sounds like what they are doing (and was what I had done.) They use the laprascope (sp)to look, but take everything out vaginally. I had a great recovery and was up as fast as I could - I had to GO (they removed my cath in recovery.)

I wish you well on your journey!

TLH with organs removed vaginally is not the same as an LAVH. I had a TLH and my surgeon morcellated my uterus and removed it vaginally. It was not an LAVH because the actual surgery was done completely laparoscopically, and not a combination of laparoscopically and vaginally. Having said that, as Mj69catz suggests, you might want to clarify with your doctor what exactly will be done.

Lucky you if you don't need to go through bowel prep. I did, but fortunately, it was only a Fleet enema, which sounds better than the other procedures I've read about here.

What you described about the catheter, cystoscopy, etc. mirrors my own experience. I stayed overnight and the catheter was removed the next morning. Once I was able to pee and walk around, I was discharged.

Good luck with everything!

To clarify, the difference between the TLH and the LAVH really isn't how the uterus is removed. The uterus can be delivered vaginally with both.

The difference is in how the procedure is done. With the TLH, all of the work is done through the lap incisions. This includes completely separating the uterus from its supporting structures, anchoring ligaments, and creating the vaginal cuff. At times, the uterus may be morcellated and removed through the lap incisions, but not always.

With the LAVH, the uterus is separated from its upper supporting structures through the lap incisions, then the rest of the work is done vaginally including separating the uterus from the lower supporting structures, anchoring ligaments, and creating the cuff.

Best wishes on your upcoming surgery (((nd2know)))!

Oh my.. that is really good information to know.
I had no idea the two surgeries (LAVH and TLH) were so different- yet so alike. I really would have to say it doesn't matter how its done as long as it gets done and safely.
BUT I will try to ask her before surgery. Doc didnt clarify and I didnt know to ask at the time.
She is going to look at the gallbladder and appendix (protocol possibly) to see if they look inflamed. So I would guess most of the work is going to be done laparoscopically with vaginal removal. Im just hoping it doesnt convert to a large abdominal incision but if it needs to happen.. I dont have any choice.
I just want to feel better.
Thank you for the well wishes, and as always, Im scared (just like everyone else is) but Im going through with it this time.

I'm having the daVinci RATLH/BSO next week. I saw someone here mention a video on youtube that was on a news show of the whole surgery so I watched it. I had laproscopic gallbladder removal and it was taken out the holes, of course. I was thinking with the daVinci would be removed through the holes, too.

What I saw on the video and what the surgeon performing the hyst explained was that once the uterus is freed, it is removed vaginally and they temporarily use it to block the opening at the top of the vagina while they sew that up. The reason he said they did that was to keep the gases they pump into your abdomen to give them room to maneuver from escaping while they stitch things closed. Hearing that made it make more sense to have the uterus come out vaginally.

I asked my Dr. about that and she confirmed that is they way she would be doing things and why. I also asked her if that meant they would be making any cuts in the vagina area to remove it that way (because I have not had children) and she said no to that. She also told me that way they don't have to make the holes in your abdomen as large as they did with my gallbladder laproscopic surgery.