Laparoscopic Hysterectomy with Anterior Repair or Posterior Repair

Laparoscopic Hysterectomy with Anterior repair is a combined operation: Using laparoscopic surgical tools, a surgeon removes the uterus through an incision in the vagina, and the Anterior repair is done at the same time. A Vaginal Laparoscopic Hysterectomy is the removal of the uterus (womb) and the cervix through a small cut in the top of the vagina with the use of Laparoscopic surgical tools. The usual reasons for performing a vaginal hysterectomy are heavy periods or a prolapsed womb. An Anterior Repair is done for women who have a prolapse. It may sometimes be performed to treat stress incontinence (leaking urine when laughing, coughing, sneezing etc). It involves making a cut in the vaginal wall and closing the skin closer together to reduce the bulge in the vaginal wall. When the operation is performed to treat a prolapse of the front wall of the vagina it is called an anterior vaginal repair.

Before the Procedure

Your physician will also conduct a full physical exam—including blood and imaging tests.

Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your health care provider which drugs you should still take on the day of your surgery.

On the day of your surgery:

• You very often will be asked not to drink or eat anything for 6 – 12 hours before the surgery.

Take the drugs your health care provider told you to take with a small sip of water. Your health care provider or nurse will tell you when to arrive at the hospital

Laparoscopic Hysterectomy with Anterior Repair or Posterior Repair

Once in the operating room, you will receive either a spinal and/or general anesthesia before the surgery to keep you from feeling pain. The choice of anesthesia is a decision that will be made by anesthesia based upon your history and your wishes. If you receive a general anesthesia, after you are asleep and before the surgery starts: a tube to help you breathe will be placed in your throat.

Another tube will be placed in your stomach to remove any gas or other contents to reduce the likelihood of injury during the surgery. The tube is usually removed before you wake up.

A catheter will be inserted into your bladder to drain urine and to monitor the amount of urine coming out during surgery.

Compression stockings will be placed on your legs to prevent blood clots in your legs and lungs during surgery. Using laparoscopic surgical tools, a surgeon removes the uterus through an incision. The Anterior repair is done at the same time.

The Operation takes between 30 and 100 minutes

Recovery

You will be taken to the recovery room and monitored for a short time before going to the observation unit.

Depending on the length of your surgery, you may not be able to eat or drink anything until the next morning or you will be started on a liquid diet. When you are feeling better you may return to a regular diet.

You may have cramping, feel bloated, or shoulder pain.

You may have a scratchy or sore throat from the tube used for your anesthesia.

You will:

• Be given medications for pain and nausea if needed.
• Have the tube in your bladder removed in recovery room.
• Have the compression stockings on your legs to improve circulation.
• Be restarted on your routine medications.
• Be given a small plastic device at your bedside to help expand your lungs after surgery.
• Start walking as soon as possible after the surgery to help healing and recovery.
• Stay in the hospital 23 hours.

Risks

Although there can be problems that result from surgery, we work very hard to make sure it is as safe as possible. However, problems can occur, even when things go as planned. You should be aware of these possible problems, how often they happen, and what will be done to correct them.

Possible risks during surgery include:

• Bleeding
• Conversion to an open surgery requiring an up and down or Bikini incision.
• Damage to the bladder, ureters and to the bowel
• Blood clot in the legs or lungs
• Bowel obstruction
• Hernia
• Incision opens Infection
• Scar tissue