Laparoscopic hysterectomy (uterus removal)

Laparoscopic hysterectomy is a modern method of removing the uterus with low trauma and fast recovery. The procedure is performed using a video camera and special instruments that are inserted through small punctures in the abdomen. This avoids large incisions and speeds up recovery after surgery.

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What is a hysterectomy?

This is the name of a surgical operation for the total removal of the uterus, which leads to the cessation of menstruation and the loss of the ability to bear children. Hysterectomy is performed strictly for medical reasons in the presence of diseases that pose a threat to the health or life of a woman. The operation is not a primary method of treatment; it is resorted to only in cases where conservative therapy has proven ineffective.

Thanks to the development of surgical technologies and the introduction of laparoscopic methods, hysterectomy is performed with minimal trauma, a low risk of complications and a shorter recovery period.

What is a hysterectomy?

Preparing for hysterectomy

Includes a set of diagnostic, therapeutic and organizational measures. Their goal is to identify possible risks, stabilize the body's condition and ensure the safest possible intervention.

At the preparation stage, the patient is prescribed a number of mandatory tests:

  • General and biochemical blood tests
  • Urine test
  • Coagulogram (assessment of blood clotting)
  • Ultrasound of the pelvic organs
  • ECG and fluorography
  • Smears for microflora and oncocytology (PAP test)
  • Determination of blood type and Rh factor

In the presence of concomitant diseases, a consultation with a therapist, cardiologist, endocrinologist and other specialists may be required. In some cases, additional MRI of the pelvis, hysteroscopy or diagnostic laparoscopy are performed. If the patient has abnormalities in the tests or has chronic diseases, their drug correction is carried out before the operation.

General recommendations before hysterectomy:

  • 7-10 days before the procedure, you should give up alcohol and reduce smoking
  • 2-3 days before the procedure, it is recommended to switch to a dietary diet, excluding foods that cause increased gas formation (legumes, cabbage, carbonated drinks)
  • A light dinner is allowed the day before the operation, a cleansing enema or laxatives are recommended on the doctor's recommendation
  • On the day of the operation, you must not eat or drink (strictly adhere to the fasting regimen), it is advisable to take a hygienic shower, do not apply creams, deodorants and makeup

Proper preparation reduces the risk of complications, facilitates the course of anesthesia and promotes rapid recovery after hysterectomy.

Types of Hysterectomy

The operation is performed in different ways, their choice depends on the diagnosis, concomitant diseases, the woman's reproductive plans and the technical capabilities of the clinic. All methods are aimed at removing the uterus, but differ in access to the organ, the scope of the intervention and the duration of recovery.

Laparoscopic hysterectomy

A minimally invasive method of removing the uterus, performed through small punctures (5-10 mm in diameter) in the anterior abdominal wall. The doctor inserts a laparoscope (an optical device with a video camera), which makes it possible to see the internal organs on the screen in an enlarged form, as well as to control the manipulations using surgical instruments.

Advantages of the laparoscopic method:

  • Minimal tissue trauma due to the absence of a large incision
  • Low risk of blood loss and infectious complications
  • Short hospitalization period (in most cases 1-3 days)
  • Fast postoperative period - return to active life is possible after 2-3 weeks
  • Good cosmetic result - small punctures heal quickly and do not leave noticeable marks on the skin

Laparoscopic hysterectomy is considered the "gold standard" for planned removal of the uterus, especially in women of working age. The minimally invasive nature of the operation allows you to reduce the load on the body, reduces the risk of adhesions and postoperative hernias, reduces the psychological stress associated with hospitalization and recovery. Patients tolerate the procedure more easily, return to work and their usual rhythm of life more quickly, without experiencing significant discomfort.

Laparotomic hysterectomy

The operation is performed through an incision in the lower abdomen - usually horizontal (along the bikini line), less often vertical (in case of oncology or a very large uterus). This is a classic method used in complex clinical situations (large myomatous nodes, severe adhesions, suspected oncology, the need for simultaneous removal of appendages, lymph nodes and surrounding tissues).

Disadvantages of laparotomic hysterectomy:

  • More severe tissue trauma. Unlike laparoscopy, laparotomy involves an incision in the abdominal wall, which leads to greater damage to muscles and fascia
  • High risk of postoperative pain. Due to the large-scale intervention, patients often experience discomfort in the early postoperative period, which requires the use of analgesics
  • Long recovery period. After laparotomy, restrictions on physical activity remain for up to 6 weeks.
  • Increased risk of complications. The main ones are wound infection, suture suppuration, hematoma formation, intestinal paresis, and development of postoperative hernia
  • Pronounced cosmetic defect. Even with a horizontal incision in the bikini area, a noticeable scar may remain, especially if the skin is prone to rough scarring
  • Longer hospitalization. Usually, patients are hospitalized for 5 to 7 days (sometimes longer, depending on the condition)

Despite all the shortcomings, laparotomic hysterectomy remains an indispensable method in gynecologic oncology and in emergency conditions when wide access and control over the pelvic organs is required. The choice of intervention method is always individual, the attending physician selects it taking into account the clinical situation and the patient's safety.

General information

Technique of the operation

Laparoscopic hysterectomy is performed under general anesthesia. The operation requires precision, experience of the surgeon and special equipment. Surgical instruments and a camera are inserted through small punctures in the abdomen.

The surgical intervention is carried out according to the following algorithm:

  1. Positioning the patient. The woman lies on the operating table in a position with a raised pelvis and slightly apart legs (Trendelenburg position). This improves visualization of the pelvic organs
  2. Processing the surgical field. The abdomen and perineum are treated with an antiseptic, then covered with sterile sheets
  3. Insertion of instruments. A needle is inserted through a small incision near the navel and carbon dioxide is pumped in. This creates the necessary space for work in the abdominal cavity. Then the doctor inserts a laparoscope (camera), and through additional punctures – surgical instruments
  4. Assessment of anatomy. The surgeon examines the pelvic organs, assesses the scope of the intervention and determines the order of actions
  5. Isolation and removal of the uterus. The ligaments, vessels, and fallopian tubes are successively intersected and coagulated. The uterus is removed through the posterior vaginal fornix or by morcellation (grinding the organ in a sealed container for safe extraction through a puncture)
  6. Bleeding control. The vessels are coagulated or tied. If necessary, the vaginal fornix is sutured
  7. Completion. After removing the instruments, carbon dioxide is removed from the abdominal cavity, cosmetic sutures or special adhesive bandages are applied

The average duration of laparoscopic hysterectomy is 1-2 hours.

Effect and results of the operation

Hysterectomy helps to quickly and effectively eliminate the cause of the disease, improve the patient's quality of life. If the operation is performed correctly and there are no complications, the effect of the intervention is persistent and pronounced.

Main results:

  • Elimination of symptoms. After removal of the uterus, complaints associated with the underlying disease disappear, namely heavy menstruation, chronic pelvic pain, bleeding, pressure on neighboring organs
  • Stabilization of the condition. Patients' hemoglobin levels are normalized (in case of blood loss), their well-being improves, anxiety and nervousness associated with unpleasant symptoms and fear of oncology decrease
  • Prevention of complications. The operation prevents the development of more severe conditions (degeneration of fibroids, rupture of the uterus with severe prolapse or progression of cancer)
  • In cancer. Hysterectomy is a vital stage of treatment and can increase the duration and quality of life of the patient

At the same time, after surgery with extirpation of the uterus, a woman faces some changes. What is important to consider:

  • Menstruation stops forever. This is a natural result of the operation, which does not require drug correction
  • Loss of fertility. The woman can no longer get pregnant, which is important to consider when planning a family
  • Hormonal levels are maintained (if the ovaries were not removed). The patient does not enter menopause, typical "climacteric" symptoms do not occur
  • Sexual life after the adaptation period (4-6 weeks) in most cases remains full. If the vaginal vault is preserved and there are no complications, the function is not impaired

It is important to understand that the emotional and psychological reaction to the operation may be individual. Some women need time to adapt, especially if the hysterectomy was performed at a young age. Support from the doctor, relatives and psychologist (if necessary) helps to overcome this stage without stress.

Recovery after surgery

Rehabilitation after laparoscopic hysterectomy is easier than after abdominal surgery. A woman can get out of bed a few hours after the procedure, and go home after 1-3 days.

The first day after the surgery, the patient is under the supervision of doctors, pain relief and monitoring of vital signs. Moderate pain, bloating, weakness are possible. At this time, it is important to:

  • Start early activity (getting up, short walks)
  • Wear compression stockings to prevent thrombosis
  • Follow a diet with easily digestible food

After discharge, it is necessary to continue a gentle regimen. Despite the low-trauma nature of the surgery, the body needs time to recover. In the first 2-4 weeks, it is recommended to:

  • Avoid physical activity and heavy lifting
  • Do not take hot baths, do not visit the sauna or pool
  • Temporarily exclude sexual intercourse
  • Keep the punctures clean, treat them with an antiseptic

The diet should be balanced, with an emphasis on proteins, vegetables and sufficient fluids. It is important to avoid foods that cause gas and constipation.

You should seek immediate medical attention if:

  • Temperature above 38 °C
  • Sharp abdominal pain
  • Heavy discharge with an unpleasant odor
  • Bleeding
  • Difficulty urinating or defecating

Full recovery usually takes 4-6 weeks. A follow-up examination by a gynecologist is performed 7-14 days after the operation. If the woman feels well, she is allowed to gradually return to physical activity, including sports and work.

The psycho-emotional state is also important. Some patients worry about the loss of reproductive function. In such cases, do not hesitate to seek support from a psychologist.

Possible complications and risks

Although laparoscopic hysterectomy is considered a safe procedure, like any surgical intervention, it is associated with certain risks:

  • Bleeding. Requires monitoring and, if necessary, re-intervention
  • Infection. Possible in the puncture area, in the vagina or inside the abdominal cavity. Manifested by fever, pain, purulent discharge
  • Damage to adjacent organs. The bladder, ureters or intestines can be accidentally injured by surgical instruments
  • Thromboembolism. Formation of blood clots in the veins of the lower extremities or their movement to the lungs
  • Intestinal paresis. Temporary disruption of intestinal motility after anesthesia. Manifested by bloating, delayed bowel movements, discomfort
  • Adhesive disease. The formation of connective tissue can cause pain or infertility (with preserved ovaries)
  • Hematoma in the suture area. Accumulation of blood under the skin or in the puncture area. Usually goes away on its own, but may require treatment
  • Prolapse of the vaginal fornix. A rare complication that occurs with a weak pelvic floor. Requires subsequent correction
  • Postoperative hernia. May occur in the puncture area due to impaired healing or excessive loads
  • Cicatricial changes. Rough scarring, pigmentation, or discomfort in the suture area. More common in patients with a tendency to keloids

To reduce the risk of complications, it is important to strictly follow preoperative preparation and doctor's instructions during the recovery period.

Indications for hysterectomy

The main indications for hysterectomy:

  • Uterine fibroids (leiomyoma) - the intervention is carried out in case of large tumor sizes, its rapid growth, compression of adjacent organs or heavy uterine bleeding
  • Adenomyosis (internal endometriosis) - characterized by the proliferation of the endometrium into the muscular layer of the uterus, pain, heavy menstruation and anemia
  • Heavy and prolonged uterine bleeding - especially in premenopause, if hormonal therapy is ineffective
  • Prolapse of the uterus - a violation of the normal position of the organ with prolapse into the vagina. Accompanied by pain, urinary incontinence and discomfort
  • Cancerous and precancerous diseases – of the cervix or body of the uterus, ovaries or fallopian tubes, high-grade dysplasia
  • Endometrial hyperplasia with atypia – a precancerous condition that is accompanied by the proliferation of the inner layer of the uterus
  • Chronic pelvic pain – caused by diseases of the uterus that do not respond to other types of therapy
  • Postpartum complications – heavy bleeding, infection or rupture of the uterus

Sometimes hysterectomy is performed for prophylactic purposes in patients with a high risk of cancer, for example, in the presence of hereditary Lynch syndrome or BRCA mutations.

The decision on the need for surgery is made by a gynecologist based on diagnostic data, individual characteristics and prognosis of the disease. The patient's age, reproductive plans and the presence of concomitant pathologies play an important role.

Contraindications to surgery

Absolute contraindications to surgery:

  • Severe decompensated chronic diseases (heart, kidney, liver failure), in which general anesthesia is dangerous
  • Blood clotting disorders that cannot be corrected with medication
  • Acute infectious disease with severe intoxication (sepsis, pneumonia, etc.)

Absolute contraindications suggest that surgery cannot be performed due to high risks to the patient's life. In such situations, the doctor offers alternative methods of therapy.

Relative contraindications:

  • Acute inflammatory processes in the pelvic area (salpingo-oophoritis, endometritis) - surgery is possible after eliminating the infection
  • Acute acute respiratory viral infections, flu, herpes in the acute stage - planned intervention is postponed until complete recovery
  • Anemia, diabetes in the decompensation stage, arterial hypertension - require stabilization of the condition before surgery
  • Pregnancy - except in cases where emergency surgery is indicated due to a threat to the woman's life
  • Obesity grades 3-4 (especially with laparoscopic access) - requires preoperative weight correction
  • Allergy to drugs used for anesthesia or pain relief - it is necessary to select safe alternatives

Before the operation, a full examination of the woman is carried out to assess the risks and choose the best treatment tactics. This approach allows to increase the safety and effectiveness of the intervention.

Cost of the operation

In the medical center "K+31" in Moscow, the operation is performed according to modern standards using minimally invasive technologies and under the supervision of experienced gynecologists. The clinic has modern equipment, individual rooms and a high level of medical safety.

The cost of laparoscopic hysterectomy depends on a number of factors:

  • The scope of the intervention (removal of only the uterus or with appendages)
  • The presence of concomitant diseases
  • The need for additional diagnostics or treatment

The current price for the operation can be clarified during an in-person consultation at the clinic. The doctor will select an effective treatment strategy and offer optimal conditions, including cost.

Cost of the operation

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Udin Oleg Ivanovich
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Korolev Sergei Vladimirovich
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In 2023, I was admitted to the clinic with acute cholecystitis. My attending physician was Dmitry Alexandrovich. It is difficult to find a more attentive doctor. He explained every stage of my examination and treatment, and then the operation. He was always in touch. When a patient is confident in the qualifications and calmness of the doctor, then nothing is scary. Dmitry Alexandrovich answered my questions after the operation! But recently my mother was admitted to the clinic with the same problem, and we were lucky that Dmitry Alexandrovich was the attending physician. On the day of the operation, my mother's arm was paralyzed. And it was decided to postpone the operation. Dmitry Alexandrovich immediately called a neurologist and prescribed additional examinations. Serious problems were excluded and the operation was performed two days later. Everything went well! Mom was safely discharged home two days later. Such a doctor inspires confidence and helps to calm down!
28.08.2025
S. Christina
I would like to express my gratitude to the surgeon Dmitry Alexandrovich Semenov for his high professionalism and respectful attitude towards the patient! Thank you very much!
28.08.2025
G. Peter
The doctor consulted me and signed me up for a future operation. The doctor answered all my questions quite competently. I liked that Oleg Ivanovich has professionalism and human qualities.
25.08.2025
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I received proper consultation from the doctor, and all my questions were exhausted. The doctor is competent, treated me attentively. I will recommend him to others. He found the cause, corrected the incorrectly prescribed treatment.
25.08.2025
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I have varicose veins, I had a consultation with phlebologist Ivanchik I.Ya., according to the results of tests and ultrasound, an operation is ahead of me, I would like to thank you for the informative consultation. It is nice to feel that you are in good hands. Thank you for your care and professionalism.
25.08.2025
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Everything was at a high professional level.
23.08.2025
Ts. Irina Gennadievna
The doctor gave me detailed advice on the post-operative wound with a diagnosis of epithelial coccygeal tract with abscess. He examined the wound carefully and gave advice on dressings.
17.08.2025
S. Nikita Sergeevich
I had surgery with surgeon-oncologist Dzhamilov Sh.R. I am very happy that I got to this doctor, the surgery was quick, successful, without complications, the doctor clearly explained why the puncture was needed. The cosmetic suture is almost invisible, very delicately done by the surgeon. My best recommendations to Sherali Radzhabalievich! And in general I am very happy with the service of the clinic, everything is at the highest level!
08.08.2025
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the doctor is reasonable, attentive and smart. You rarely meet him in modern medicine
30.07.2025
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