Laparoscopic hysterectomy and vaginal hysterectomy are two techniques used by gynecological surgeons to remove the uterus. The patient’s anatomy and other guidelines influence decisions concerning the type of hysterectomy that should be performed.
During vaginal hysterectomy, an incision is made in the vagina allowing the uterus to be removed. Vaginal hysterectomy eliminates the need for an abdominal incision and leaves no visible scar.
Advantages to vaginal hysterectomy include:
- No external incision
- Healing time may be shorter
- Less pain during recovery
- Fewer complications than with other surgical approaches
- Reduced hospital stay
- Faster return to normal activities
- More cost-effective, in many cases
Although vaginal hysterectomy is the preferred choice for many women, it is not appropriate for every patient.
Reasons vaginal hysterectomy might not be recommended:
- Uterine size or shape makes removal through the vagina difficult
- The uterus is not accessible through a vaginal approach
- Adhesions, severe endometriosis or uterine tumors may interfere with a vaginal approach
- Additional procedures are required
Laparoscopic hysterectomy is performed through the use of a laparoscope, a narrow, lighted tube that is inserted into a small incision in the bellybutton area. Other small incisions may also be required for additional instruments.
During laparoscopic hysterectomy, your gynecologist will detach the uterus and remove it in small pieces.
Advantages to laparoscopic hysterectomy:
- May reduce the need for abdominal hysterectomy
- Less blood loss as compared to abdominal hysterectomy
- Lower wound infection rates than with abdominal hysterectomy
- Faster recovery time and reduced hospital stay
Reasons for performing laparoscopic hysterectomy:
- As an alternative to abdominal hysterectomy when vaginal hysterectomy is not possible
- Allows a clear view of pelvic and abdominal structures
- May facilitate removal of a large uterus
- Used for patients with severe endometriosis, adhesions and uterine masses or tumors
Women in whom hysterectomy is medically indicated should discuss the surgery with their gynecologist and consider all appropriate options.