Laparoscopic Supracervical Hysterectomy – LSH

There are approximately 600,000 hysterectomies performed each year in the United States. Hysterectomy is the 2nd most common major operation in the United States (Cesarean is #1). Approximately 1 in 3 women have undergone hysterectomy by the age of 60. 

This outpatient procedure involves laparoscopic removal of the uterine body, and the patient is able to keep her cervix. The patient can either keep her ovaries or have them removed at the same time. Fallopian tubes are often removed since it is now believed that fallopian tubes are the source for some types of ovarian cancer. Pelvic supports are left intact. 

This outpatient approach is associated with less pain, less bleeding, less infection, fewer adhesions, and a quicker recovery than the open approach. This is a nice way to manage a large fibroid uterus without having to do a big incision. Other conditions, such as endometriosis and adhesions, can be treated at the same time. Pelvic support procedures can be performed at the same time.

Total Hysterectomy vs. Partial, Subtotal, Supracervical Hysterectomy

Total Hysterectomy (“hyster” means uterus, “ectomy” means to remove) is the removal of the uterine body and cervix. Partial, Subtotal, Supracervical Hysterectomy is removal of the uterine body and the patient keeps the cervix. 

“Total” hysterectomy makes no statement regarding the ovaries and fallopian tubes. Removal of ovaries and fallopian tubes is a separate term (oophorectomy and salpingectomy, respectively). Ovaries and fallopian tubes can be removed or kept in place with either total or partial hysterectomy.

Indications For Hysterectomy

Pain, Bleeding, Uterine Fibroids, Pelvic Prolapse, Malignancy, Pelvic Inflammatory Disease, some cases of Adenomyosis, and some cases of Endometriosis. Many years ago, before we had modern Anesthesia, Blood Banks, and Antibiotics, all hysterectomies were partial. There was mortality with simple procedures, and the goal was to complete the surgery as rapidly as possible. Since modern Anesthesia, Blood Banks, and Antibiotics, for decades all hysterectomies were total. Today, both Total and Partial/Supracervical Hysterectomy are done safely with excellent results depending on the indication and patient wishes.