Office

2828 Maplewood Ave., Suite B

Winston Salem, NC 27103

Office: (336) 794-1444

Fax: (336) 794-1477

Hours of operation:

8:30 a.m. to 4:30 p.m.

Monday through Thursday.

8:30 a.m. to 2 p.m.

Friday

View Map

Laparoscopic Supracervical Hysterectomy

Laparoscopic Supracervical Hysterectomy or LSH is performed when the uterus is too large to access through the vagina alone. This is generally the case with large uterine fibroids. This procedure is done through the “ band aid” incisions described above. The uterus (and ovaries if indicated) are accessed from above instead of below in the case of the TVH. The tissues around the uterus are divided with the help of a bipolar energy source to prevent bleeding. Fibroids are fed by larger than average blood vessels and care is taken to control these effectively. Once the uterus is freed, the uterus (and ovaries if needed) is divided from the cervix which is the lower aspect of the uterus. A morcellator is used to grind the uterus into strips which can be removed through the laparoscopic ports in the abdominal incisions.

This is truly a subtotal hysterectomy since the cervical part of the uterus remains while the body of the uterus which is where the menstrual flow originates is removed. Patients must have a normal pap smear and test negatively for the virus which causes cervical cancer to be a candidate. Pap smear screening must continue for the patients whose cervix remains. Since the uterus is ground into strips, the lining of the uterus is evaluated before the surgery with ultrasound and biopsy to ensure no lurking cancer or precancerous conditions exist. Ten percent of patients may experience persistent menstrual flow although it is generally described as mild monthly spotting at the time they would expect a normal period if there remains a small area of uterine lining at the top of the junction between the uterus and the cervix. Altho this is rarely of concern to the patient, it can be treated in the office with simple cautery with local anesthesia.

LSH is truly an advanced laporoscopic procedure which is designed to provide a woman with a large uterus which cannot be accessed by the vaginal route and would otherwise require and abdominal incision and a longer recovery. The recovery for an LSH includes going home the same day or the following day from the hospital, return to work in 7-10 days and return to normal activities including sexual intercourse in two weeks since there is no vaginal incision. Since this is a more difficult procedure, patients are carefully counseled about the possibility that the abdominal hysterectomy may be necessary if the patient’s uterus proves to be impossible to safely be removed laporoscopically.