Total Laparoscopic Hysterectomy (TLH)

Total Laparoscopic Hysterectomy (TLH) is a minimally invasive surgical procedure performed by gynecologists to remove the uterus using laparoscopic techniques, specialized instruments, and advanced technology

First Stage: This stage begins with the onset of labor and continues until the cervix is fully dilated (10 centimeters). Contractions become stronger and more frequent, and the cervix gradually opens to allow the baby to pass through the birth canal.

Here’s an overview of the TLH procedure:

Purpose and Indications:
Uterine Removal: TLH is performed to remove the uterus entirely, addressing various gynecological conditions, disorders, or indications necessitating hysterectomy, such as uterine fibroids, endometriosis, adenomyosis, pelvic organ prolapse, abnormal uterine bleeding, chronic pelvic pain, gynecological cancers (e.g., endometrial cancer, cervical cancer), or other relevant medical or reproductive health concerns.
Minimally Invasive Approach: TLH offers a minimally invasive alternative to traditional open hysterectomy, enabling reduced surgical trauma, smaller incisions, less postoperative pain, shorter hospital stays, faster recovery, and improved cosmetic outcomes for eligible patients.

Surgical Technique:
Laparoscopic Access: The TLH procedure is performed using a laparoscopic approach, involving several small incisions (typically 3 to 4) in the abdominal wall through which specialized laparoscopic instruments and a laparoscope (a thin, lighted telescope) are inserted to access and visualize the pelvic and abdominal structures.
Uterine Dissection and Removal: Under laparoscopic guidance, the surgeon carefully dissects, mobilizes, and disconnects the uterus from surrounding tissues, blood vessels, and ligaments, ensuring meticulous hemostasis (control of bleeding) and preserving adjacent anatomical structures as appropriate. The uterus is then removed through one of the incisions or morcellated into smaller fragments for extraction, depending on the surgical approach, uterus size, and clinical considerations.

Postoperative Care and Recovery:
Recovery and Monitoring: Following TLH, patients are monitored in a recovery area, and vital signs, pain management, incision care, urinary function, and overall well-being are assessed. Most patients experience a shorter recovery period, reduced postoperative discomfort, and quicker return to daily activities compared to open surgery.
Follow-up and Support: Regular postoperative follow-up appointments, evaluations, assessments, counseling, or additional treatments may be scheduled to monitor recovery progress, evaluate pathology results, assess surgical outcomes, address concerns, and provide ongoing support and guidance as needed.

Considerations and Risks:
Patient Selection: Patient selection, preoperative evaluation, medical assessment, surgical planning, and eligibility criteria for TLH are determined based on individual clinical indications, medical history, pelvic anatomy, uterine size, pathology, surgical expertise, and relevant considerations to optimize outcomes and safety.
Potential Risks: As with any surgical procedure, TLH carries potential risks, complications, or adverse events, including infection, bleeding, injury to adjacent structures, anesthesia reactions, urinary tract injuries, bowel injuries, vaginal cuff dehiscence, postoperative complications, or other unforeseen issues, necessitating careful preoperative assessment, informed consent, vigilant intraoperative technique, and appropriate postoperative care to minimize risks and ensure optimal surgical outcomes.

Total Laparoscopic Hysterectomy is a valuable surgical option in gynecology, offering a minimally invasive approach to hysterectomy with potential benefits in selected patients, contributing to enhanced surgical care, patient recovery, and overall satisfaction in managing various gynecological conditions, disorders, or indications requiring uterine removal across diverse clinical scenarios, preferences, and healthcare contexts.

• Preconception Planning
• Conception
• Confirmation of Pregnancy
• Prenatal Care
• Nutrition and Lifestyle Changes
• Medical Monitoring and Screening
• Education and Preparation for Childbirth
• Labor and Delivery
• Postpartum Care
• Bonding and Parenting