5 Types of Minimally Invasive Hysterectomy Procedures

Approximately one-third of women in the United States have had a hysterectomy by the age of 60. Until recently, women only had a few hysterectomy options that required an abdominal or vaginal incision.

Today, women benefit from less pain, shorter hospital stays, faster recovery and small scars through minimally invasive hysterectomy (MIH) procedures.
 

There are five types of MIH procedures:

  • Laparoscopic supracervical hysterectomy (LSH). A laparoscope and small surgical instruments are inserted through small incisions in the navel and abdomen. The uterus is detached from the cervix and removed through one of the incisions. The procedure can be performed on an outpatient basis and patients can typically be discharged within 24 hours.
  • Total laparoscopic hysterectomy (TLH). This procedure is very similar to LSH except the entire uterus, including the cervix, is removed through the vagina, while the surgeon is still working with laparoscopic instruments in the abdomen. It is also an outpatient procedure, and discharge is typically within 24 hours.
  • Laparoscopically assisted vaginal hysterectomy (LAVH). During this procedure, a miniature camera is inserted through a small incision to view the uterus and surrounding organs. Using the view from the laparoscope, the uterus is detached using special tools inserted through small incisions in the abdomen. An incision is then made at the top of the vagina, and the uterus and cervix are removed through this incision.
  • Vaginal hysterectomy (VH). A small, nonvisible incision is made at the top of the vagina, and the uterus and cervix are removed through the vagina. During a VH, the abdominal walls are not stretched, which alleviates some of the pain and discomfort. Many times a vaginal hysterectomy is not an option due to uterine size and the size of the vagina.
  • Robotic-assisted total hysterectomy. This procedure is very similar to the total laparoscopic hysterectomy with the addition of the daVinci robotic surgical system. After the laparoscopic intruments are placed into the patient’s abdomen, they are attached to the daVinci system. The surgeon performs the operation using a console. The uterus is then removed through the vagina or through the laparoscopic incisions.
 
The risks of minimally invasive procedures are similar to the risks associated with abdominal or vaginal hysterectomies.

Although minimally invasive surgery is appropriate for many patients, not everyone is a candidate. Talk to your doctor about the best treatment option for you.

The Christ Hospital offers all of these MIH options

​Dr. Ruchhoft is board-certified in obstetrics and gynecology. She received her medical degree from the University of Cincinnati and completed her residency at Baylor College of Medicine in Houston, TX. She has served the women of Greater Cincinnati for more than 15 years and is a member of the North American Menopause Society and the Cincinnati Obstetrics/Gynecology Society.