Laparoscopic Supracervical Hysterectomy (LSH)

Hysterectomy is the definitive solution for persistent and heavy uterine bleeding, symptomatic fibroids and adenomyosis. Hysterectomy is performed after conservative pharmacological and surgical measures are exhausted.

Traditional types of hysterectomy include Total Abdominal Hysterectomy (TAH) and Total Vaginal Hysterectomy (TVH). Laparoscopic hysterectomies may be subdivided into Laparoscopically Assisted Vaginal Hysterectomy (LAVH), Total Laparoscopic Hysterectomy (TLH) and Laparoscopic Supracervical Hysterectomy (LSH).

TAH requires a several inches long abdominal incision and a vaginal incision. This increases the postoperative pain and creates a disfiguring scar. In order to achieve proper surgical exposure, retractors and bowel packing are employed which also cause postoperative pain and slow down resumption of bowel function. Postoperative recovery necessitates a two to four night hospital stay and about six week recuperation at home.

TVH requires only a vaginal incision and does need vaginal retractors. Pain and recovery are improved as compared to TAH. Still, the patient needs to stay one to two nights in the hospital and about four weeks at home for recovery.

LAVH requires vaginal and laparoscopic incisions. Hospital stay and recovery at home are similar to TVH. The choice between TAH, TVH and LAVH usually depends on the comfort level and training of the surgeon.

TLH requires vaginal and laparoscopic incisions but has no need for vaginal retractors. Usually, it is an outpatient surgery and patient needs about two weeks of recovery at home. TLH includes removal of the cervix.

Having performed over 500 LSH procedures, Dr. Mordel notes that LSH avoids the unpleasant scars, eliminates the need for retractors and bowel packing and significantly reduces postoperative pain and recovery time. There is no vaginal incision. Only three tiny abdominal incisions are required. One, one-half inch umbilical (navel) incision, and two, one-fifth inch side incisions are made. LSH is essentially sutureless and bloodless.

LSH generates less pain than any other hysterectomy. Special energy sources are used to seal and divide the blood vessels and to detach the uterus from the cervix and the ovaries. A special device, called a morcellator is utilized to cut the uterine specimen into strips that are removed through a one-half inch diameter umbilical port. Patients usually go home six to eight hours after surgery and return to normal activities in about two weeks. Preservation of the cervix saves some of the blood supply and nerve network and therefore may preserve pelvic floor function, including sexual response.

Learn more about chronic pelvic pain, endometriosis, fibroids or persistent bleeding.