Laparoscopic Supracervical Hysterectomy – LSH
Advantages of Supracervical Hysterectomy
Patients felt it might be better for sexual function. In regards to intercourse after hysterectomy, it is more related to why the procedure was done. If a significant medical problem was resolved, sexual activity will likely be improved. Advantages of Supracervical Hysterectomy:
a) Protecting pelvic supports. Supporting tissues between bladder and vagina, between rectum and vagina, and uterosacral and cardinal ligaments at the bottom of the pelvis, all insert into the cervix. With Supracervical hysterectomy these attachments remain intact. Pelvic Prolapse can occur even when there has been No prior pelvic surgery. Therefore, Supracervical Hysterectomy does Not prevent prolapse, it just does not do anything to bring Prolapse on.
b) Lower infection rate. The cervical canal is a smaller communication between the vagina and abdominal cavity, as compared to the open vaginal apex in total hysterectomy, with less contamination of the abdominal cavity.
c) Less risk of trauma to the bladder. Total removal of cervix requires more mobilization of bladder.
d) no risk for postoperative separation of the incision at the top of the vagina
Disadvantages of Supracervical Hysterectomy
Pain and bleeding from the cervix. If the endocervical canal is not removed, then significant bleeding may persist. If the surgeon removes most of the endocervical canal, leaving supportive tissues on the outer portion of the cervix, then cervical bleeding will be minimal or none. All patients who choose Supracervical Hysterectomy need to accept: Patient need to continue cervical cancer screening (pap smears) and may need more complicated surgery later is the cervix needs to be removed. There can pain, bleeding, infection, adhesions, dysplasia of the cervix requiring medical/surgical treatment and/or removal of the cervix later on. Surgical choice is based on specific patient concerns, taking into account what is important to the patient.
Frequently Asked Questions About Laparoscopic Supracervical Hysterectomy
What is the uterus made up of?
The uterus is a thick muscular organ that consists of 3 parts: cervix, uterine body, and uterine fundus. The fundus is the upper portion of the uterus above where the fallopian tubes attach. The uterine body is the major portion of the uterus between the uterine fundus and cervix. The cervix is the lower part of the uterus that communicates with the vaginal canal. Hysterectomy (“hyster” means uterus, “ectomy” means to remove) is removal of the uterus.
How are total, partial, and supracervical hysterectomies different?
Removal of the entire uterus, including the cervix, is called total hysterectomy. Removal of the upper uterus (uterine body and fundus), conserving the cervix, is called partial hysterectomy. Since partial hysterectomy is above a portion of the cervix, this is also known as supracervical hysterectomy. These procedures can be done by laparotomy (open) or by laparoscopy (endoscopic).
How safe and common are hysterectomies?
Many years ago, before blood banks, antibiotics, and modern anesthesia, surgery was dangerous with high mortality. Surgical procedures were kept as short as possible, and all hysterectomies were partial hysterectomies. With the advent of blood banks, modern anesthesia, and antibiotics, total hysterectomies were performed. Total hysterectomy and supracervical hysterectomy are both good procedures being performed today.
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