How is a laparoscopic (minimally invasive) hysterectomy performed, and is every case suitable for laparoscopic surgery?

Hysterectomy is one of the most commonly performed surgeries in gynecology and obstetrics. In the past, this surgery was performed through open surgery (laparotomy), but today it is increasingly carried out using laparoscopic (minimally invasive) or vaginal approaches. In appropriate cases, even for cancer patients, minimally invasive surgical techniques can be safely applied.

However, there are certain conditions where laparoscopic surgery may not be feasible. Patients who cannot undergo general anesthesia or those with lung diseases such as asthma and bronchitis may not be suitable candidates for this approach. Additionally, patients for whom an increase in intracranial pressure is risky should also avoid laparoscopic surgery.

During a laparoscopic procedure, carbon dioxide gas is introduced into the abdomen to create pressure, and the patient is positioned head-down. If increased intra-abdominal pressure or this positioning poses a risk, laparoscopic surgery is not recommended. However, in other cases, laparoscopic surgery is a viable and effective option.

Even in patients with a large uterus, those who have undergone multiple previous abdominal surgeries, or those with severe obesity, laparoscopic surgery can be performed successfully by experienced surgeons. The primary advantages of this technique include faster recovery, significantly less pain, and reduced bleeding. In suitable cases, patients can even be discharged on the same day. Studies have shown that patients with stable post-operative conditions and the ability to consume food orally can safely return home.

After laparoscopic surgery, patients can start oral intake within the first four hours. If they feel well, they can consume liquids and semi-solid foods. For those with adequate urinary output, the urinary catheter can be removed within 4-6 hours. Generally, solid foods are introduced the day after surgery, and patients who can walk unassisted and have no significant pain can be discharged.

Hysterectomy is commonly performed in patients with large fibroids or severe pain due to endometriosis (chocolate cysts). While it may sometimes be classified as a complex surgery, it can still be safely performed laparoscopically using appropriate surgical techniques. Laparoscopic hysterectomy follows similar surgical principles in both cancerous and benign (non-cancerous) conditions.

Laparoscopic surgery is especially crucial for obese patients diagnosed with uterine cancer. According to the European Society of Gynecological Oncology, the majority of patients with uterine cancer should undergo minimally invasive surgery to meet quality standards. This approach not only ensures better clinical standards for surgical centers but also enables patients to recover faster and receive timely additional treatments if necessary.

In conclusion, laparoscopic hysterectomy offers numerous benefits for both surgeons and patients in suitable cases. Wishing all our patients a healthy and prosperous life.