A Gynecologist's Second Opinion:
The Questions & Answers You Need to Take Charge of Your Health
(Second Edition, Revised)
by William H. Parker
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  Patients who undergo laparoscopic hysterectomy experience a shorter hospital stay with most patients ready to go home the day after surgery.

Laparoscopic Supracervical Hysterectomy


Quick Facts


Procedure Description:

Laparoscopic Supracervical Hysterectomy (LSH) preserves sexual function by saving the cervix and its mucous-secreting glands, avoiding vaginal dryness, the most common complaint after other hysterectomies. Few surgeons are trained for this advanced procedure. LSH is a partial hysterectomy that preserves your cervix, and often your ovaries, removing only the diseased uterus.

What To Expect:

LSH causes less vaginal dryness because the glands of the cervix secrete mucous, avoiding the most common complaint of all other hysterectomies (vaginal dryness). LSH also affords better pelvic support, because the ligaments that support the cervix and vagina are left intact. LSH leads to less pain and quicker recovery compared to traditional hysterectomies because of the small incisions used in the laparoscopic approach. Sparing of the ovaries in most cases, avoids the need for hormone replacement. To read more about this procedure see the Laparoscopic Supracervical Hysterectomy - OBGYN.net Interview.

Pre-procedure:

A complete history and physical exam including a pap smear and a vaginal ultrasound are performed at the time of the first visit, with other pre-surgical testing depending on your condition. You do not qualify for LSH if you have a history of precancerous cervical pathology because of the risk of developing cancer in the future.

Post-procedure:

Recovery from laparoscopic surgery is significantly faster and less painful than recovery from traditional surgery. Moreover, laparoscopic supracervical hysterectomy has been shown to have the shortest operating times and the shortest hospital stays compared to any other type of hysterectomy. LSH also leads to quicker resumption of sexual activity with better vaginal support. Because the cervix is saved, you will still require yearly pap smears.


Comparative Benefits of Laparoscopic Supracervical Hysterectomy
  TRADITIONAL GOOD BETTER BEST
  Procedure Total Abdominal Hysterectomy Vaginal
Hysterectomy
Laparoscopically Assisted Vaginal Hysterectomy Laparoscopic
Supracervical
Hysterectomy
  Acronym (TAH) (VH) (LAVH) (LSH)
  Incision Site Abdomen Inner vagina Belly button/vagina Abdomen (4 small incisions
  Hospital Stay 5-6 days 1-3 days 1-3 days Outpatient to 1 day
  Recovery Time 6 weeks 4-6 weeks 4-6 weeks 2-3 weeks
  Retention of   Cervix Upon request No No Yes
  Indications AUB*, large fibroids, severe endometriosis, pelvic infection/scarring AUB*, utero-vaginal prolapse, smaller fibroids  AUB*, utero-vaginal prolapse, smaller fibroids  AUB*, fibroids
  Contraindications   Large fibroids Large fibroids Large or numerous fibroids

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