Our Summary

This research paper describes a method of performing a type of hysterectomy (surgical removal of the uterus) called laparoscopic extrafascial hysterectomy. The study was done to prevent injury to the ureter (the tubes that carry urine from the kidneys to the bladder) during this surgery. The researchers used 10 cadavers to measure the distance between certain points related to the uterus and the ureter to determine the safest way to perform the surgery. They then applied this technique in actual surgeries performed from 2006 to 2014 at Poissy University Hospital. Out of the 68 patients who underwent this procedure, none experienced any complications with their ureters. This suggests that this technique is a safe and effective way to perform a hysterectomy while protecting the ureter.

FAQs

  1. What is a laparoscopic extrafascial hysterectomy?
  2. How did the researchers ensure the safety of the ureter during the laparoscopic extrafascial hysterectomy?
  3. What were the results of the surgeries performed using this technique at Poissy University Hospital between 2006 and 2014?

Doctor’s Tip

A doctor might tell a patient undergoing a laparoscopic hysterectomy to follow their post-operative instructions carefully, including taking pain medication as prescribed, avoiding heavy lifting, and resting as needed to ensure a smooth recovery. They may also advise the patient to contact them immediately if they experience any unusual symptoms such as severe pain, heavy bleeding, or signs of infection.

Suitable For

Patients who are typically recommended for laparoscopic hysterectomy include those with conditions such as:

  1. Fibroids: Noncancerous growths in the uterus that can cause heavy menstrual bleeding, pelvic pain, and pressure on the bladder or bowel.

  2. Endometriosis: A condition where tissue similar to the lining of the uterus grows outside of the uterus, causing pain and sometimes infertility.

  3. Adenomyosis: A condition where the inner lining of the uterus grows into the muscle wall, causing heavy menstrual bleeding, severe cramps, and pressure in the pelvis.

  4. Uterine prolapse: A condition where the uterus slips down into the vagina due to weakened pelvic floor muscles, causing pelvic pressure and urinary incontinence.

  5. Gynecologic cancers: Hysterectomy may be recommended as part of treatment for cancers such as endometrial, cervical, or ovarian cancer.

  6. Chronic pelvic pain: Hysterectomy may be considered for women with severe, chronic pelvic pain that has not responded to other treatments.

  7. Abnormal uterine bleeding: Hysterectomy may be recommended for women with persistent, heavy menstrual bleeding that does not respond to other treatments.

It is important for patients to discuss their individual medical history, symptoms, and treatment options with their healthcare provider to determine if laparoscopic hysterectomy is the best option for them.

Timeline

Before laparoscopic hysterectomy:

  1. Consultation with a gynecologist to discuss symptoms and treatment options
  2. Pre-operative tests and evaluations to ensure the patient is a suitable candidate for surgery
  3. Education on the procedure, risks, and recovery process

During laparoscopic hysterectomy:

  1. Anesthesia is administered
  2. Small incisions are made in the abdomen for the laparoscope and surgical instruments
  3. The uterus is removed using minimally invasive techniques
  4. The surgery typically lasts 1-2 hours

After laparoscopic hysterectomy:

  1. Recovery in the hospital for 1-2 days
  2. Pain management and monitoring for complications
  3. Follow-up appointments with the surgeon to monitor healing and address any concerns
  4. Return to normal activities within 4-6 weeks, depending on individual recovery progress.

What to Ask Your Doctor

  1. What are the potential risks and complications of a laparoscopic hysterectomy?

  2. How long is the recovery time after a laparoscopic hysterectomy?

  3. Will there be any scarring after the procedure?

  4. How long will I need to stay in the hospital after the surgery?

  5. Will I still be able to have children after a laparoscopic hysterectomy?

  6. Are there any alternative treatment options to a laparoscopic hysterectomy?

  7. How often do you perform laparoscopic hysterectomies, and what is your success rate?

  8. Will I need to take any medications or follow a specific diet after the surgery?

  9. How soon can I return to normal activities and exercise after a laparoscopic hysterectomy?

  10. What follow-up care will be needed after the procedure?

Reference

Authors: Nyangoh Timoh K, Paquet C, Lavoué V, Touboul C, Fauconnier A. Journal: Surg Radiol Anat. 2019 Aug;41(8):859-867. doi: 10.1007/s00276-019-02242-7. Epub 2019 May 6. PMID: 31062091