Minimally Invasive

Total Laparoscopic Hysterectomy Laparoscopic Assisted Vaginal Hysterectomy

Transobturator Sling

Total Laparoscopic Hysterectomy

The total laparoscopic hysterectomy removes the uterus and cervix.  Typically everything is removed in one piece unless the uterus is very large. This procedure is similar to the supracervical hysterectomy except that the uterus and cervix are removed through the vagina. The vagina is then closed by suturing the highest point of the vagina with a series of sutures done  with laparoscopic instruments. Permanent sutures are also put in place to help support the vaginal so that there is a reduced risk of prolapsed later on.

Some of the advantages of TLH is that it can be performed on women who have never had children, women who have had surgeries before, women with narrow vaginas, women with cancer, and women with enlarged organs. Women who need a hysterectomy, but do not qualify to have a vaginal hysterectomy are perfect candidates for this surgery. The total laparoscopic hysterectomy is the least painful and least debilitating route for removal of the uterus and cervix.

Laparoscopic Assisted Vaginal Hysterectomy

Laparoscopic assisted vaginal hysterectomy (LAVH) is done using a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina.

During LAVH, several small incisions are made in the abdominal wall. Then slender metal tubes known as "trocars" are inserted through the incisions. This provides passage for a laparoscope and other microsurgical tools. The laparoscope acts as a tiny telescope, which has a camera attached to it.

During the procedure, the uterus is detached from the pelvis using the laparoscopic tools. If the Fallopian tubes and ovaries are to be removed, they are also done at this time. Everything is then removed through a small incision made in the vagina.

The incisions made during a LAVH are very small. The scars, pain, and recovery time are significantly less than with a traditional abdominal hysterectomy. It is also less physically traumatic than a routine vaginal hysterectomy. When LAVH is viable option, it has distinct advantages.

Transobturator Sling

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