Laparoscopically Assisted Vaginal Hysterectomy (LAVH) is a minimally invasive surgical procedure of the removal of the uterus through the vagina. The uterus is the organ where the baby develops during pregnancy, placed right above the vagina. Bilateral Salpingo-Oophorectomy (BSO) is the removal of cervix, uterus and both ovaries and fallopian tubes in one surgical procedure.
In LAHV, a small incision is made on the abdominal wall to permit the laparoscope to enter the abdomen or pelvis. The ovaries and fallopian tubes are removed through the vagina while the laparoscope provides an unobstructed view to the surgeon. A laparoscope is a long tube with an attached light and camera at its end.
The insertion for LAVH is relatively small leading to less pain and less blood loss. The recovery time is also shorter. It can be done in patients who have not had children and a more feasible option. A hysterectomy for Bilateral Salpingo-Oophorectomy is done due to multiple reasons.
At Apollo Cradle, Nehru Place we provide complete healthcare and top-class medical facilities to make your stay with us as comfortable as possible. Our doctors and healthcare professionals are experienced in conducting every procedure with utmost care making the whole process a pleasant one.
Why are patients advised to have this surgery?
There are various reasons for having hysterectomies done.
Removal of cancerous cells.
There might be the growth of cancerous cells in your uterus walls or tissue on the cervix which needs to be removed. There are other procedures for a different type of cancer like radiation and chemotherapy. One should refer to an oncologist.
Fibroids
Fibroids are the most common reason for LAVH and the only solution. These are benign uterine tumors that if left untreated can lead to anemia, pelvic pain, bladder pressure and persistent bleeding. But women have minimal symptoms of fibroids that might not need attention.
Endemetriosis
Endemetrium, a tissue lining in the uterus sometimes starts growing outside on the fallopian tubes, ovaries and cervix. This sometimes leads to pain and bleeding not responding to other treatments.
Uterine Prolapse
This is a condition when the uterus descends into the vagina due to sagging and weak supporting tissues and ligaments. This leads to difficulty in bowel movement, pelvic pressure and urinary incontinence.
Heavy bleeding
Abnormal vaginal bleeding that could not be treated with other methods like medicines, Dilatation and Curettage (D&C), a hysterectomy might be the solution. Irregular and heavy period with intense pelvic pain leads one to remove their uterus and related organs.
One should have carefully evaluated all the consequences of this surgery before undergoing it for an unnecessary hysterectomy can lead to more complications. One should be aware that one cannot get pregnant after getting LAVH done. If you want to conceive in the future this procedure is not for you. Also after LAVH with BSO, one should consider Hormone replacement therapy to get accustomed to the sudden deficiency of hormones like estrogen from your body.
How to prepare for the procedure
It is always apprehensive to undergo surgery and one should be well prepared for the process.
Get information
Refer to your doctor and healthcare assistance at every step of the surgery. Get information and be well aware of the procedure to make an educated choice. Having the required information always gets you comfortable with the method leading to trouble-free surgery.
Follow instructions
Make sure your doctor is aware of all your medical record and medication routine. Get clear instructions from your doctor on any change in the dietary pattern or usual medication that might need to be stopped before the day of the surgery. These include any over the counter medication, herbal preparations and dietary supplements.
Anesthesia
You need to make a clear choice about the kind of anesthesia you would like to use. For LAVH with BSO one can get general or regional anesthesia (spinal or epidural).
Plan your stay
Depending on the nature of your surgery and anesthesia type your stay at the hospital might change. Some women can leave within a few hours after the surgery or might need to stay back for 1 or 2 days.
Post surgery help
Make sure to have someone available to take care of you after your surgery. You might need several weeks before you can get back to a normal routine and have restricted diet. You cannot do strenuous work or lift heavy objects right after the surgery.
You might be required to take a few tests before the surgery.
Cervical Cytology (Pap-Test)
This test is done to check for abnormal cervical cells or cervical cancer.
Endometrial Biopsy
The abnormal growth of endometrium or presence of cancer in the uterine wall is checked through this test.
Pelvic ultrasound
The size of the uterine fibroids, ovarian cysts, or endometrial polyps are checked.
You will receive a preoperative cleansing of your vagina. And is advised to take a bath with a particular cleanser given by the doctor on the day of the surgery.
What happens during the procedure?
The patient is administered anesthesia depending on the type chosen.
During LAVH, incisions are made either vertically or horizontally on the abdominal walls near the belly button to allow passage of metal tubes called ‘trocars’. The laparoscope is also inserted to view the inside of your belly inflated with carbon-di-oxide. Another tube is passed through the vaginal walls to remove the ovaries, uterus, fallopian tubes and cervix from the ligaments with which they are connected to the body.
After the uterus has been removed, the vaginal wall is sealed and the laparoscope and other tools are removed from the body. The other cuts and incisions near the belly button are also sealed.
Post surgery effects to keep in mind
After the surgery, you might be kept for a few hours to monitor your body for pain or other discomfort. Anaesthesia will take some time to wear off. You will be asked to sit and walk and given medicines for pain or nausea immediately after the surgery.
You may need to wear a catheter tube for a few days after the surgery and your doctor will tell you when the catheter can be removed. Some times there can be a pain in your right shoulder due to inflation of body with gas but this usually goes away in a day or two.
The cuts from the procedure will heal but will leave a permanent scar in your body.
Recovery
It will take up to 3 months to fully recover from the surgery. You can take a few precautions to ensure the recovery going smooth.
- Get plenty of rest
- Avoid lifting heavy objects
- Monitor excessive vaginal bleeding
- Monitor signs of infection
- Wait until 6 weeks before having intercourse
- Stay active but avoid heavy exercises
- Eat health food
