The growing trend in all of the surgical specialties over the last few decades has been to perform surgical procedures that are minimally invasive.  What is minimally invasive surgery?  The term has been used to describe any procedure (surgical or otherwise) that is less invasive than open surgery used for the same procedure.  Recent advances in technology have made it possible to perform hysterectomies using laparoscopic techniques in patients whom vaginal hysterectomy cannot be accomplished.

There are several methods to perform a hysterectomy: vaginal, laparoscopic, and abdominally.  Vaginal hysterectomy is considered minimally invasive.  It involves removing the uterus through the vagina. Laparoscopic hysterectomy is considered minimally invasive as well.  It involves removing the structures that connect the uterus to the pelvis through several small incisions on the abdomen.  The uterus is removed through the vagina in a total laparoscopic hysterectomy (TLH).  An abdominal hysterectomy is accomplished through either a low transverse incision or midline incision on the abdomen.

Benefits of minimally invasive surgery include: less pain/discomfort, decreased length of hospital stay, decreased hospital expense, less incidence of adhesion formation, and decreased recovery time which translates into resuming activities of daily living sooner as well as returning to work much sooner.  Being able to return to work sooner also translates to less loss of income.

In May of 2011, a meta-analysis of randomized clinical trials was published in the American Journal of Obstetrics & Gynecology which compared vaginal hysterectomy to total laparoscopic hysterectomy.  The conclusions were somewhat surprising.  To summarize the clinical implications, the following points were noted:

• Recently published studies have begun to investigate the role of total laparoscopic hysterectomy in women suitable for vaginal hysterectomy
  

• TLH is superior to vaginal hysterectomy (VH) in terms of postoperative pain and length of stay but takes longer to perform

• The best available evidence does not demonstrate a difference in incidence of perioperative complications between VH and TLH; the nonsignificant increase in Dindo grade III complications seen in association with TLH was limited to a single trial and demands further study.

• Long-term studies to determine effects on future prolapse, incontinence, and sexual function are needed to aid gynecologists in determining the optimal approach to benign hysterectomy

If interested, you may view the study by following this link: Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized clinical trials.

Dr. Flores can perform whichever method of hysterectomy is best suited for your condition and circumstances.  Though it is preferred to perform the surgery in a minimally invasive manner, there are instances in which the minimally invasive method is not possible (e.g., extremely large uterus with large fibroids, extremely dense adhesions, etc.).  Dr. Flores is currently the only provider performing Total Laparoscopic Hysterectomy (TLH) within an 85 mile radius.

305 W. 15th Street, Suite 104

Liberal, KS 67901

 (620) 624-9637

Over the years, the surgical specialties have been developing surgical techniques that aim to decrease patient discomfort, recovery time, and hospital expenses while allowing the patient to resume activities of daily living as well as returning to employment as soon as feasibly possible.  Laparoscopic hysterectomy achieves all of those goals.