Laparoscopic supracervical hysterectomy (LSH) may be the surgical solution for many women who suffer from small to medium fibroids, adenomyosis, abnormal bleeding or endometriosis. Who should consider LSH? Women who have tried less invasive therapies such as endometrial ablation and hormone therapy without success are good candidates for laparoscopic supracervical hysterectomy. Why would a woman want to consider LSH? The procedure can significantly reduce the symptoms which may occur after more radical forms of hysterectomy.



What is laparoscopic supracervical hysterectomy? This fairly new approach to hysterectomy is accomplished through small incisions in the abdomen. A laparoscope (a slender optical tube which allows the physician to look inside the pelvic cavity) is inserted through the first incision. Instruments for cutting the uterus away from its blood supply are inserted through subsequent incisions. Once the uterus

has been detached from the interior of the body, it is cut into small strips. The small strips are then pulled out through the previous incisions. An LSH leaves the ovaries and the cervix intact.

What are the benefits of not removing the ovaries and the cervix as part of a hysterectomy? By leaving the ovaries a woman is not subjected to the immediate onset of surgical menopause. In most cases, after a laparoscopic supracervical hysterectomy menopause will occur naturally and on much the same schedule as it would have had a hysterectomy not taken place. Sometimes, because of reduced flow to the ovaries, there may be some menopausal symptoms associated with a hysterectomy in which the ovaries are not excised. The cervix acts as an important supportive tissue for many pelvic ligaments. Removing it may destabilize the entire area. Additionally, leaving the cervix can diminish vaginal dryness and decreased sexual desire which are sometimes side effects from a total hysterectomy. A total hysterectomy is an operation in which both the uterus and the cervix are taken out.

Does laparoscopic supracervical hysterectomy pose additional risks beyond those inherent in more traditional hysterectomy? Any hysterectomy is major, traumatic surgery which should not be undergone without great thought. However, LSH as a procedure presents negligible increased risk over conventional hysterectomy procedures. Still, a woman should be aware that she remains vulnerable to cervical and ovarian cancer after having a laparoscopic supracervical hysterectomy.

Therefore, it is imperative that she stay in close contact with her physician and continue to take all the recommended cancer screening tests on the schedule advised by her doctor.

Hysterectomy has become increasingly controversial in recent years. Still, for women who have chronic reproductive diseases, hysterectomy may represent the best solution to their problems. Those who suffer from non-malignant maladies may want to consider laparoscopic supracervical hysterectomy as it is far less invasive. LSH also offers the potential for avoiding many menopausal symptoms which may rear their heads after other types of hysterectomy. Only after consultation with her gynecologist can a woman make a fully informed decision on whether laparoscopic supracervical hysterectomy is the right procedure for her specific ailments.