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Unread 04-06-2002, 06:37 PM
laproscopic hysterectomy

Subj: laparoscopic hysterectomies?
Date: 04/05/2002 10:27:09 PM Eastern Standard Time
From: Dlrfoto

Hello everybody,
I'm new here.

I have had endometriosis since '89 and have recently been diagnosed with adenomyosis. I also have a number of fibroids. I have been through 3 surgeries, two laparoscopies and one laparotomy (removal of my right ovary after a ruptured endometrioma). I have taken all sorts of hormones. Most recently Danazol which I had to discontinue after 3 months because of elevated liver enzymes. That brings me to today pretty much. I have had the acute onset, doubled over on the floor, making deals with God (who I only seem to believe in at such times), kind of pain as well as the daily stuff. ...cramps, pain in back, fatigue, flu like symptoms, bloating, nausea etc. I'm going to be 44 in May and was told yesterday, by Dr. Farr Nezhat (Do you know him?...he seems pretty renowned in the field of endometriosis) a hysterectomy was advisable. I was seeing another Doctor for about 12 years but he is sick now. Back in October he and I had discussed a hysterectomy. He's the one who put me on the Danozol even though I had an adverse reaction (elevated liver enzymes) 13 years ago. I think he thought we should take a more conservative (if you can call danazol conservative)...less invasive approach. Anyhow, I keep changing my mind every other day as to whether or not to have a hysterectomy. Dr. Nezhat can do it laprascopicly. I am wondering if any of you have had the procedure done that way. I feel like Dr Nezhat isn't someone who would lightly recommend one and right now I'm really leaning that way. Of course that might change tomorrow.

Any thoughts would be greatly appreciated.
Thanks In Advance.
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Unread 04-06-2002, 07:53 PM

Hi dlrfoto!! *wave*

I'm certainly not a doctor, I can only talk to you from my experience that I've had with endo. I've been dealing with pain from endo since I was 14 years old. I'm 33 now and had a TAH/BSO on 2/13/02. I feel wonderful and believe it was the very best choice for me. The pain was starting a week BEFORE my period and lasting 3 days after. Pain in my back, nausea, and of course the cramping. I'm a member of the Endo Association and have read quite a bit about Endo and have learned a lot about different types of hysterectomies from talking with my doctor and reading things on this Hyster site. I've heard of a lap-assisted hysterectomy, but I would be scared of it with endo because endo is common on other organs besides the uterus. I've had 2 laproscopies to laser endo in the past, then one laproscopy this past January and that's when my doctor recommended the hyster. After the first 2 laps, I was on Lupron, which really made me depressed, so I was unable to take it. Now I'm on Premerin and feeling really wonderful. NO MORE PAIN!!!!

Hope this helps a bit in your decision. Hang in there and listen to your body and check with different doctors if you need to - get second and third opinions if you need to.

BIG *hug* for you!!!
Unread 04-06-2002, 10:25 PM

I had a LAVH on 3/11/02. It is supposed to be a shorter healing period by about two weeks. You don't have a big incision on the outside, but you still have all that surgery on the inside, so you have to take it easy.

If you decide to go that way, your doctor will tell you that once they get in there and look around, they may decide to do your surgery abdominally (that's what I was told, anyway). If you have a lot of adhesions, they may have to do it TAH.

I had some endo, but no ways near what you appear to have. However, if you have been suffering for as long as you have (since 89)...I think you will find that a hyster will definitely improve the quality of your life.

Good Luck!

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Unread 04-07-2002, 08:10 AM
laproscopic hysterectomy

Thank you both so much for your response. Everyone is very kind and supportive here! I can't quite figure out how to respond publicly on the message board, if that's even the right term...I'm a bit of a cyber klutz, so I hope this is going to get to you. Marsha, I was wondering what LAVH actually stands for??? I can see this site is going to teach me alot! I am planning on having a total hysterectomy...uterus, ovary (already had one removed) + cervix. I did ask the doctor about the possibility of him having to switch to a full abdominal surgical procedure once he gets in there with the laproscope and sees what's going on but he says he's rarely...maybe once...had to do that. Having already been through a laporodomy I certainly would like to avoid another. I forgot to ask the doctor where the incisions for the laproscopes would be. I guess I assumed they'd be in the same place as before but now I'm thinking they're going to go thru the vagina. Is that what your surgery was like Marsha?

Thanks again for responding,

XO, Donna
Unread 04-07-2002, 10:20 AM


LAVH stands for Laproscopic Assisted Vaginal Hysterectomy. This is what your doctor is planning to do to you. (I also had a BSO which stands for bi-lateral salpingo oopherectomy--removal of both tubes and ovaries). There is a post at the top of the message boards that is about the abbreviations used was all new to me when I came on this board,, don't feel bad about not knowing them. In time, you'll be spouting the lingo, too! LOL

If your surgery can be done this way (and it appears that your doctor prefers it), you should go for it...I think. You won't end up with a big inscision, and it is supposed to be a little easier than a regular abdominal Hyst.

My doctor made three inscisions about an inch long each to do my hyst: one in my navel; and one on each side of my lower abdomen...kinda like this (- ' -)...If you can imagine that being my tummy and the marks my inscisions. That was it for the hyst. My uterus, cervix,tubes, and ovaries were delivered out of my vagina and then the top of my vagina was sewn shut (that is called a vaginal cuff).

I ended up with two more, tinier inscisions down on my outer vagina (labia majora toward the mons), becuase they did a SPARC bladder neck suspension, too, and that is where the mesh was pulled through my skin. (If you are having any incontinence problems, this is the time to get it fixed).

I felt like I had been run over by a truck after it was over, but other people haven't had much pain with the LAVH. It just depends on the person. I recommend getting a morphine pump after your surgery (or demerol pump) doctor didn't give them to LAVH patients. Ask your doctor about it, and if you want one--demand it! I wish I had.

I feel pretty good, now, and tomorrow I will be four weeks post op.

If you have had bad experiences with Lapro surgery before, it was probably the gas they use to blow you up so they can get to everything. Ask your doctor to express as much as he can after the surgery is over, and before they sew you up. It is pretty painful trying to get that stuff out, but walking around some as soon as you can gets it moving. I remember having to use my childbirth breathing in the hospital, when those waves of gas started through.

You should think about getting the Hystersister has a lot of down to earth information in it. I learned a lot from it and this website...and I continue to learn.

Hope this helps. Good Luck!

Unread 04-07-2002, 10:34 AM
laproscopic hysterectomy

I also have endometriosis and have read up on it too. I have heard of your doctor and that he is one of the best in the entire country for helping women with endo. I think you are in very good hands. I even considered traveling to see him after reading so many good things about his work with women and endo. Fortunately I found a doctor here in Atlanta who has a passion to learn about endo and helping women with it. I don't think your doctor is the type to lightly advise a hysterectomy, but if you are still unsure I would recommend a second opinion for you. My doctor will also be doing a LAVH. I have read that they can visualize more with the scope that magnifies things then with just the visual eye that they would use when they open you up. If they found things were too extensive then they would go in abdominally. That is what they plan to do with me. The colon surgeon even said that he can do my bowel resection with the laprascope, so they have come a long way. I think it is good to start out with the laprascope and they can always change over to abdominally if they must.

On good days I am feel like I am making a mistake about having a hysterectomy and on the bad days I wish I had had it "yesterday." It is normal to be afraid of making a mistake or thinking there is another way. You do have a choice though. Ask the doctor what your choices are and then use the one that is least invasive. If you can live with it great, but if you can't because you continue to suffer immensely or have great pain then the hysterectomy is probably right for you. Wishing you all the best, and may God bless you.
Unread 04-07-2002, 10:40 AM
laproscopic hysterectomy

Thanks Marsha. You have been a big help. I'm going to order the hystersister book and I will definitely ask for morphine (my drug of choice). I'm curious, since it sounds like I'll be having the same thing done as you had, how long you were in the hospital for?? The two previouse laparoscopies I had were suppose to be day procedures but I needed to be in the hospital overnight because I was in such bad shape. I'm looking into the possibility of having a spinal instead of general anesthisia since that always makes me feel so sick and from what I've heard it takes awhile to get out of your system.

Hope you're not getting sick of all my questions.
Unread 04-07-2002, 10:51 AM
laproscopic hysterectomy

thanks Jerianne. Dr, Farr Nezhat has 2 brothers who also specialize in Endo and I believe one of them practices in Atlanta. Good luck with your surgery. Please let me know how you're doing. I am going to Holland for about 2 weeks and when I get back I think I will have the surgery...maybe. lol
Unread 04-07-2002, 11:01 AM


Ask all the questions you want...I am just glad to be able to help.

I was in the hospital for a little over 48 hours, and that is only because I had the bladder surgery, also. With the LAVH, you should only be in the hospital for about 24 hours, if you don't have any post op complications. But in the end, it all depends on you and your doctor.

I absolutley hate the hospital, so I was chomping at the bit to get the heck out of there!

I was lucky in that the anesthesia didn't make me sick at all, but the women that I sared rooms with were both really sick from it. Tell the doctor about your concerns, and your Anesthesiologist. I think they can give you an extra med, while you are under that will help with the sickness. As far as getting it out of your system...the main thing to do is get it out of your lungs (the gas is heavier than air, and if it lays around in your lungs it will cause pnuemonia). They give you a "blow toy" to help you with that. Just be sure to do those "blow toy" exercises as often as you can. They are a little hard on the tummy, but the coughing is good for you, at that point.


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