Laparoscopic hysterectomy

Complete laparoscopic removal of the uterus with Fallopian tubes and ovaries is a recent operative advance. There are a variety of procedures, options including:

• laparoscopically-assisted vaginal hysterectomy: laparoscope is only used to ligate ligaments
• laparoscopic hysterectomy: infundibulopelvic, round and broad ligaments and uterine artery are ligated laparoscopically. The uterus is delivered vaginally.
• total laparoscopic hysterectomy: the uterus is removed abdominally
• modifications of the above, e.g. suturing ligaments to reinforce the remaining structures

Laparoscopic hysterectomy may necessitate as little as two days' hospital admission. However, certainly with the vaginal route, it is still a major procedure. Until more long-term evaluation has been made, laparoscopic hysterectomy may be best reserved for those patients who have not gained benefit from endometrial ablation or resection.