Laparoscopic Hysterectomy with/without Bilateral
Salpingo-oophorectomy

Indication

   Pelvic or abdominal mass

   heavy menstrual flow

   suspected cancer

The Procedure

   General anaesthesia

   Pneumoperitoneum created by insufflation of carbon dioxide

   Incisions made

   Telescope and instruments passed into abdomen

   Uterus removed (Hysterectomy)

   Bilateral salpingo-oophorectomy (removal of both Fallopian tubes and ovaries) can be done at the same time

   Uterus removed vaginally

   Vaginal wound and abdominal wounds closed

   Tissues removed will be sent for pathological examination or disposed of as appropriate unless otherwise specified

   Other associated procedures which may be necessary, such as:

   Blood transfusion

   Removal of tubes and ovaries (prophylactic or when affected)

   If removed, may need hormonal therapy. Risks of hormonal therapy include increased risk of breast cancer, deep vein thrombosis and gall stone

   If not removed, there is a 5% chance of future operation for ovarian disease

Photographic and / or video images may be recorded during the operation for education / research / documentation purpose. Please inform the staff if you have any objection.

Similarities with abdominal myomectomy

   Same pathology removed

   Same sequelae

Difference from abdominal myomectomy

   3-4 smaller abdominal wounds

   Less painful

   Faster postoperative recovery

   Earlier discharge, shorter sick leave required

Risk and Complication

   Anaesthetic complications

   Bleeding, may need blood transfusion

   Injury to neighbouring organs especially the bladder, ureters and bowels, may require repair

   Pelvic infection

   Wound complications including infection and hernia

Specific Complication

   Risk of laparotomy (less than 5% chance)

   Trauma to peritoneal organs and blood vessels

   Slight increase in risk of urinary tract injury in laparoscopic approach

Risk of Not Having the Procedure

   Progression and deterioration of disease condition

   Exact diagnosis cannot be ascertained

After the Procedure

   No menstruation

   Unable to get pregnant

   Coitus is not affected

   Should not affect hormonal status if ovaries are not removed; ovarian failure may occur 2-4 years earlier than natural menopause

   Climacteric symptoms may occur if ovaries are removed in a premenopausal woman

Alternative Treatment

   Observation

   Non-surgical treatment e.g. Medical treatment, Mirena

   Myomectomy (for uterine fibroid)

   Endometrial ablation (for dysfunctional uterine bleeding)

   Open / vaginal / hysteroscopic approach

   Uterine fibroid embolization

Follow Up

   Avoid intercourse until examination by doctor at follow up

Remarks

The information contained is very general. The list of complications is not exhaustive and other unforeseen complications may occasionally occur. In special patient groups, the actual risk may be different. For further information, please contact your doctor.