There are several types of laparoscopic hysterectomy, including:
- Total laparoscopic hysterectomy (TLH): This procedure involves removing the entire uterus, including the cervix, through the vagina. The top of the vaginal opening inside the abdomen is then sewn together using instruments inserted through a laparoscope.
- Laparoscope-assisted vaginal hysterectomy: In this operation, the surgeon inserts a laparoscope through the abdomen to inspect the upper abdomen extensively during the procedure. A surgeon might opt for this approach if the patient has pelvic adhesive disease that may have rendered a straightforward vaginal approach unsafe. This technique also may be preferred if the surgeon plans to remove the ovaries. During the procedure, the surgeon uses port access to disconnect the uterus and other structures, which then are removed through the vagina.
- Laparoscopic supracervical hysterectomy (LSH): This less-invasive approach is preferred by surgeons who believe it may be associated with a decrease in future incidence of vaginal prolapse. The surgeon detaches the uterus from the cervix but leaves the cervix and its fibrous support structures intact. The uterus is cut into small strips, which then are pulled out through ports.