Advanced Hysterectomy Technique Preserves Pelvic Support

March 1, 2008

Who is a Good Candidate for the Procedure? LSH may be a good option if you have no history of uterine cancer or abnormal pap tests, and have good support from pelvic ligaments. It is often the preferred option for women who have never had children or who have had a C-section. As a reminder, Dr. Dunn added, “Because the cervix is left in place after LSH, it is important for women who have had the procedure to continue having Pap tests on a regular basis.

Each year, nearly 650,000 women in the United States undergo a hysterectomy. There are several techniques that may be used, and the one a woman and her surgeon select depends to a great extent on the woman’s medical history and condition. Options include abdominal hysterectomy, which requires a large incision through the abdomen; vaginal hysterectomy, which involves a circular incision around the cervix to reach the uterus; laparoscopically-assisted vaginal hysterectomy, which allows the surgeon to view the pelvic area and remove the uterus vaginally; and laparoscopic supracervical hysterectomy, or LSH. During LSH, the surgeon removes only the upper portion of the uterus through an incision in the navel and leaves the cervix in place. According to K. C. Dunn, MD, PhD, a specialist in obstetrics and gynecology with advanced training in LSH, it is a technique that offers significant benefits for those women who are good candidates.

How is LSH Performed?

As Dr. Dunn explained, “During this minimally invasive procedure, several tiny incisions are made in the abdomen. Small surgical instruments are used to detach the upper portion of the uterus from surrounding tissue and the cervix. The uterus is then morcellated, or cut into tiny pieces, which are removed through a small incision in the navel.”

What are the Advantages?

LSH is usually the least painful form of hysterectomy and has the shortest recovery time. “Patients are generally home from the hospital the next day, and most can assume regular activities in about two weeks,” said Dr. Dunn. “There is also reduced scarring and lower risk of infection.” She added that the greatest benefit of this procedure over the other treatment options is that there is no disruption of vaginal support since the cervix is left in place. In addition, the lower portion of the uterus is near several important structures, and the procedure avoids this critical area.

“Many patients in our region have hobbies or jobs that require strenuous activity or heavy lifting,” said Dr. Dunn. “Unlike LSH, the other types of surgery can disrupt vaginal support and may restrict a patient’s ability to do her job or participate in activities she enjoys. They can even lead to the need for another surgery to restore support in the pelvic area.”

What Kinds of Conditions Can be Treated by LSH?

Dr. Dunn explained that abnormal bleeding is the most common diagnosis treated by LSH. Others include fibroids, pelvic pain and endometriosis.

Who is a Good Candidate for the Procedure?

LSH may be a good option if you have no history of uterine cancer or abnormal pap tests, and have good support from pelvic ligaments. It is often the preferred option for women who have never had children or who have had a C-section. As a reminder, Dr. Dunn added, “Because the cervix is left in place after LSH, it is important for women who have had the procedure to continue having Pap tests on a regular basis.