Overview
Total Laparoscopic Hysterectomy (TLH) is a minimally invasive surgical procedure in which the uterus and cervix are removed using laparoscopic (keyhole) techniques. Small incisions are made in the abdomen through which a laparoscope (a thin tube with a camera) and specialized instruments are inserted. The uterus is then detached and removed safely, often through the vaginal canal. Depending on the patient’s condition, the surgeon may also remove the ovaries, fallopian tubes, or nearby lymph nodes.
This laparoscopic hysterectomy surgery offers patients faster recovery, smaller scars, and less postoperative pain compared to traditional open procedures. At Sparsh Hospitals, our experienced gynecologic surgeons use advanced minimally invasive techniques to ensure precision, safety, and comfort throughout the procedure.
What Is TLH Surgery?
Wondering what is TLH surgery? A Total Laparoscopic Hysterectomy involves the complete removal of the uterus and cervix through small abdominal incisions using a laparoscope. The surgery is performed under general anesthesia and is typically chosen when conservative treatments such as medication or minor procedures haven’t resolved gynecologic issues.
This procedure is used to treat a range of conditions such as uterine fibroids, heavy menstrual bleeding, endometriosis, prolapse, or even certain cancers of the reproductive system. Because of its minimally invasive nature, TLH has become the preferred alternative to open hysterectomy in most cases.
When Is Total Laparoscopic Hysterectomy Needed?
A lap hysterectomy may be recommended if you are experiencing any of the following:
- Painful, heavy, or irregular menstrual bleeding (AUB)
- Uterine fibroids causing pressure or discomfort
- Prolapse of the uterus
- Endometriosis or adenomyosis
- Ovarian cysts or benign ovarian tumors
- Precancerous changes or cancer of the uterus, cervix, or ovaries
- Chronic pelvic pain unresponsive to other treatments
- Postmenopausal bleeding
Your doctor will assess your medical history, imaging results, and overall health to determine whether TLH is the best treatment option.
Diagnosis Before TLH Surgery
Before performing a laparoscopic hysterectomy procedure, your gynecologist will conduct diagnostic tests to confirm the cause of your symptoms. Common tests include:
- Pelvic ultrasound or transvaginal scan – to visualize uterine or ovarian abnormalities
- MRI or CT scan – to get detailed imaging of pelvic structures
- Cervical cytology (Pap smear) – to rule out cervical cancer or dysplasia
- Endometrial biopsy – to detect abnormal or precancerous cells along the uterine lining
These diagnostic steps ensure accurate assessment and surgical planning.
TLH Surgery Steps
The TLH surgery steps at Sparsh Hospitals are carefully designed to minimize risk and promote faster recovery.
- Anesthesia and Preparation: The procedure is performed under general anesthesia. A catheter is inserted into the bladder to keep it empty during surgery.
- Insertion of the Laparoscope: A small incision (about 1–2 cm) is made near the navel to insert the laparoscope. The abdomen is filled with carbon dioxide gas to create working space.
- Placement of Instruments: Two to three additional tiny incisions are made to insert specialized surgical instruments for manipulating and cutting tissues.
- Detachment of Uterus and Cervix: The uterus and cervix are carefully detached from their surrounding ligaments and blood vessels. If required, the surgeon may also remove the fallopian tubes and ovaries.
- Removal of the Uterus: The detached uterus is removed through the vagina (vaginal route) or, rarely, through a small abdominal incision if the uterus is enlarged.
- Closure and Recovery: The surgical instruments are removed, and the small incisions are closed with dissolvable sutures. Patients are moved to recovery for observation.
How long does a laparoscopic hysterectomy take?
On average, the surgery takes about 2 to 3 hours, depending on the size of the uterus and whether additional procedures are needed.
Whom is TLH Surgery suggested?
You may require total laparoscopic hysterectomy if you:
- Have benign or cancerous uterine conditions requiring removal
- Are medically fit to undergo general anesthesia
- Wish to avoid a large abdominal incision and long recovery period
- Have not had multiple complex abdominal surgeries that cause extensive adhesions
Your doctor will evaluate your overall health, age, uterine size, and prior surgical history before recommending TLH.
Who Should Avoid TLH Surgery?
Total laparoscopic hysterectomy may not be suitable for:
- Patients with an excessively large uterus (equivalent to >4 months of pregnancy)
- Severe endometriosis or dense adhesions requiring major open surgery
- Suspected malignant pelvic masses that cannot be safely removed laparoscopically
- Patients with multiple prior lower abdominal surgeries that limit safe access
Preparing for TLH Surgery
Proper preparation ensures smooth surgery and recovery. Steps include:
- Preoperative Assessment: Complete blood tests, ECG, and imaging.
- Lifestyle Adjustments: Stop smoking at least 3–4 weeks before surgery.
- Fasting: Avoid eating or drinking for at least 8 hours before the procedure.
- Medication Review: Discuss regular medications with your doctor; some may need to be paused.
- Consent and Counseling: The surgeon will explain the risks, benefits, and recovery expectations in detail.
Recovery After Laparoscopic Hysterectomy
Following laparoscopic hysterectomy surgery, recovery is typically faster than traditional open surgery. Most patients stay in the hospital for one to two days.
Common experiences after TLH:
- Mild abdominal discomfort or shoulder pain due to gas used during surgery
- Light vaginal bleeding for 1–2 weeks
- Temporary fatigue or weakness
- Small incision marks that heal within a few days
Home Care Instructions
- Take prescribed medications for pain and infection prevention.
- Keep incision sites clean and dry.
- Avoid heavy lifting or strenuous activity for 4–6 weeks.
- Use sanitary pads instead of tampons during recovery.
- Maintain a balanced diet and drink plenty of fluids.
- Avoid sexual intercourse for at least 6–8 weeks or as advised by your doctor.
Most patients can return to routine work after 4–6 weeks, depending on individual healing and the complexity of the procedure.
Possible Complications of TLH Surgery
- While laparoscopic hysterectomy is safe, potential risks include:
- Minor bleeding or infection
- Pain, swelling, or bruising near incisions
- Urinary tract infections
- Blood clots (deep vein thrombosis)
- Accidental injury to surrounding organs (rare)
- Reaction to anesthesia
- Vaginal discharge or spotting
Your surgical team at Sparsh Hospitals takes all necessary precautions to prevent these complications and ensures continuous monitoring during recovery.
Advantages of Total Laparoscopic Hysterectomy
- Smaller incisions and minimal scarring
- Shorter hospital stay and quicker recovery
- Less postoperative pain and blood loss
- Faster return to normal activities
- Lower risk of infection compared to open surgery
Why Choose Sparsh Hospitals for TLH Surgery?
At Sparsh Hospitals, our expert gynecologic surgeons specialise in advanced laparoscopic hysterectomy and minimally invasive gynecologic procedures. We combine world-class laparoscopic equipment, experienced anaesthesia support, and personalised patient care for exceptional outcomes.
Our hospital is recognised for:
- Skilled laparoscopic surgeons
- Modern operating theatres and safety protocols
- Dedicated postoperative recovery units
- Transparent treatment planning and patient counselling
A Total Laparoscopic Hysterectomy (TLH) is a safe, effective, and minimally invasive procedure for treating a range of uterine and gynecologic conditions. With expert hands and modern technology, it offers women faster recovery and minimal discomfort.
If you’re considering laparoscopic hysterectomy surgery, visit Sparsh Hospitals for a consultation with our leading gynaecologists. We ensure compassionate care, advanced surgical techniques, and comprehensive postoperative support, making Sparsh one of the best destinations for lap hysterectomy in Bangalore.
