Laparoscopic Hysterectomy
Keyhole removal of the uterus through three or four small cuts in the abdomen — for fibroids, heavy bleeding, adenomyosis and other conditions that have not settled with medicines — with less pain, a shorter hospital stay and a quicker return to daily life than open surgery.
1.5–3 hours
1–3 days
General, you are fully asleep
About 2 weeks
Overview
Months of heavy periods that leave you tired and anaemic, a fibroid that keeps growing, or pelvic pain that no tablet seems to touch — many women live with these for years before a gynaecologist mentions the word “hysterectomy”. It is a big decision, and it helps to understand exactly what the operation involves.
A hysterectomy is an operation to remove the uterus (womb). Afterwards, periods stop permanently and pregnancy is no longer possible. Depending on the condition, the cervix, fallopian tubes and ovaries may be removed or left in place — removing the uterus alone does not bring on menopause if the ovaries are kept.
In a laparoscopic hysterectomy, the surgeon works through small cuts of about 5–10 mm. The abdomen is gently filled with carbon dioxide gas to create space, a thin telescope with a camera shows the pelvic organs on a screen, and fine instruments free the uterus, which is then usually removed through the vagina. There is no large cut on the abdomen, so pain is less and recovery is faster than after open surgery.
At SKS Hospital, our gynaecologists try medicines and simpler treatments first, and advise a hysterectomy only when it is the right answer for your symptoms and stage of life. The operation is done in our operation theatre with anaesthesia, blood bank and ICU support on the same campus, and the decision about your ovaries is discussed with you well in advance.
Why it's done
A hysterectomy is considered when a problem of the uterus is seriously affecting your health or quality of life, and other treatments have not worked or are not suitable. Common reasons include:
- Fibroids causing heavy bleeding, pain, pressure on the bladder or a swelling in the abdomen
- Heavy or prolonged periods not controlled by medicines or a hormonal coil, especially with anaemia
- Adenomyosis — the lining of the uterus growing into its muscle wall — causing painful, heavy periods
- Endometriosis with severe pain, when no further pregnancy is wanted
- Uterine prolapse, where the uterus slips down into the vagina (often treated by the vaginal route instead)
- Pre-cancerous changes of the cervix or of the uterine lining, and some early gynaecological cancers
Is it right for you?
Usually a good fit
- Your family is complete and you do not wish to become pregnant in the future
- A uterus of small to moderate size, including many women with fibroids
- Symptoms that continue despite medicines or less invasive treatment
- You are fit for general anaesthesia after a check by our physician and anaesthetist
May not be suitable
- You still wish to have children — myomectomy or other uterus-sparing options are considered instead
- A very large uterus, or dense scarring from several previous operations — an open or vaginal approach may be safer
- A suspected cancer of the ovary or uterus that needs a larger staging operation planned with the oncology team
- Serious heart or lung disease, or uncontrolled BP, sugar or anaemia, until treated and brought under control
Types and techniques
Total laparoscopic hysterectomy (TLH)
The whole uterus and cervix are freed through the laparoscope and removed through the vagina, which is then closed with stitches from inside. This is the most common type of keyhole hysterectomy.
Laparoscopy-assisted vaginal hysterectomy (LAVH)
The upper attachments of the uterus are released through the laparoscope, and the rest of the operation is completed through the vagina. It is useful when the uterus is somewhat enlarged or stuck to nearby organs.
With or without tubes and ovaries
The fallopian tubes are often removed at the same time, as this may lower the future risk of ovarian cancer. Healthy ovaries are usually kept in women who have not reached menopause, to avoid sudden menopause; removing them may be advised around or after menopause, or if they are diseased.
Vaginal or open hysterectomy
For prolapse, the uterus is often removed entirely through the vagina with no cut on the abdomen. An open (abdominal) hysterectomy through a larger cut is kept for a very large uterus, suspected cancer, or when keyhole surgery cannot be completed safely.
Preparing for the procedure
- An ultrasound of the pelvis — sometimes an MRI — to map fibroids and the size of the uterus, a Pap smear and, where needed, a sample of the uterine lining (endometrial biopsy)
- Blood tests for haemoglobin, blood group, sugar, kidney and liver function and clotting, an ECG and chest X-ray as advised, and a physician and anaesthesia check
- If heavy bleeding has made you anaemic, iron tablets or injections — and sometimes medicines to stop the bleeding — are given first to build up your haemoglobin
- Blood thinners, some diabetes medicines and herbal supplements may need pausing — only on your doctor’s advice; stop smoking and tobacco as early as possible
- Do not eat for about 6–8 hours before surgery; a mild laxative may be advised the evening before
- Arrange about two weeks of help at home, and bring your reports, list of medicines and one family member
The procedure, step by step
Anaesthesia and positioning
In the operation theatre you are given general anaesthesia, so you are fully asleep and feel nothing. A urine catheter is placed, and you lie on your back with your legs supported, tilted slightly head-down to give the surgeon a clear view of the pelvis.
Keyhole access
A small cut is made at the navel and the abdomen is gently filled with carbon dioxide gas. The laparoscope is inserted, and two or three more 5–10 mm cuts are made lower down for the instruments. A device placed through the vagina moves the uterus into the right position.
Freeing and removing the uterus
The blood vessels and ligaments supporting the uterus are sealed and divided with energy instruments that control bleeding, taking care to protect the bladder and the ureters (the tubes from the kidneys). The uterus is separated from the top of the vagina and removed through it; a large uterus may need to be divided into smaller pieces to remove it.
Closing and finishing
The top of the vagina (vaginal vault) is stitched from inside, the area is checked for bleeding and the gas is let out. The small cuts are closed with dissolving stitches or skin glue. The operation usually takes 1.5–3 hours, and the removed tissue is always sent for examination under the microscope (histopathology).
Benefits and risks
Benefits
- Permanent relief from heavy bleeding, fibroid symptoms and period pain
- Smaller cuts, less pain and less blood loss than open surgery
- A shorter hospital stay — usually 1–3 days, compared with around 3–5 days after open surgery
- A quicker return to daily activities, with small scars that fade well
Possible risks
- Bleeding that needs a blood transfusion, or infection of the wounds, urine or vaginal vault — uncommon and usually treatable
- Injury to the bladder, ureters or bowel in around 1 in 100 women, which is usually recognised and repaired during the same operation
- Blood clots in the legs or lungs; early walking, leg exercises and, where needed, blood-thinning injections lower this risk
- Need to change to open surgery if keyhole surgery cannot be completed safely, for example because of heavy scarring or bleeding
- Shoulder-tip pain from the gas for a day or two; if the ovaries are removed before menopause, symptoms such as hot flushes
Recovery timeline
Day of surgery
You wake up in the recovery room with a drip and a urine catheter. Pain is usually well controlled with tablets or injections; some women feel pain in the shoulder tip from the gas. You can sip fluids within a few hours and are helped to sit up and walk the same evening or the next morning.
Day 1 to 3
The catheter is usually removed within a day, you return to a normal diet, and most women go home 1–3 days after surgery. Light spotting or a brownish discharge is normal for a few weeks. Before discharge we explain your medicines, wound care and when to come back for the histopathology report.
Weeks 1 to 2
Walk a little more every day and keep the small wounds clean and dry. Avoid lifting heavy weights, straining and long journeys. Most women return to light housework and desk work in about two weeks. Constipation is common early on, so drink plenty of water and eat fibre.
Weeks 4 to 6 and beyond
Healing inside takes around 6 weeks while the vaginal vault heals. Avoid intercourse, heavy lifting and strenuous work until your doctor advises, usually after 6 weeks. Pelvic-floor exercises help. If your cervix was kept, continue cervical screening; if your ovaries were removed, discuss menopause care and bone health with us.
When to call your doctor
- Heavy vaginal bleeding (more than a light period), or a foul-smelling discharge
- Fever above 100.4°F (38°C), chills, or redness, swelling or pus at a wound
- Increasing abdominal pain, a swollen tummy, repeated vomiting, or being unable to pass wind or stools
- Burning or difficulty passing urine, very little urine, or urine leaking from the vagina
- Pain or swelling in one leg, chest pain or sudden breathlessness
Call us on +91 86799 11029 or come straight to our 24×7 emergency department.
Alternatives
Medicines and a hormonal coil
Tablets that reduce bleeding, hormone treatment and a hormone-releasing coil (IUD) placed in the uterus can control heavy periods and adenomyosis well in many women, while iron corrects anaemia. These are usually tried before surgery is considered.
Myomectomy or hysteroscopic surgery
If you wish to keep your uterus or have children, fibroids can be removed on their own by laparoscopic or open myomectomy, and polyps or small fibroids inside the cavity of the uterus can be removed through the vagina with a hysteroscope, with no cut on the abdomen.
Endometrial ablation or embolisation
For heavy bleeding with a normal-sized uterus, destroying the lining of the uterus (endometrial ablation) may suit women who do not want a future pregnancy. Uterine artery embolisation, in which a radiologist blocks the blood supply to fibroids, is available at specialised centres; we discuss whether either suits you and coordinate referral where needed.
This page explains Laparoscopic Hysterectomy in general terms. Your doctor will advise what is right for you after examining you and reviewing your reports. Please read our medical disclaimer.
Ask about your options, the cost and your insurance before you decide. We are empanelled with major insurers and TPAs.
Your care team
Obstetrics & Gynaecology Department
Laparoscopic hysterectomy at SKS Hospital is performed by our obstetrics and gynaecology team with experienced anaesthetists and operation theatre staff, supported by the ICU, 24×7 blood bank and laboratory on the same campus.
From the first consultation and scans to surgery, your histopathology report and follow-up, the same team stays with you — working with our general surgery, urology and oncology colleagues whenever your condition needs it, and explaining each step to you and your family.
Other departments involved
Related procedures
Hysteroscopy
A thin camera passed through the cervix into the uterus to find and treat polyps, fibroids and causes of abnormal bleeding.
Laparoscopic Myomectomy
Keyhole removal of fibroids while keeping the uterus, for women who wish to preserve fertility or avoid a hysterectomy.
Ovarian Cyst Surgery
Laparoscopic removal of ovarian cysts, saving healthy ovarian tissue wherever possible, with a short stay and quick recovery.
Pap Smear & Cervical Screening
A quick, simple test that picks up early changes in the cervix years before they could turn into cancer.
Laparoscopic Gallbladder Surgery
Keyhole removal of the gallbladder for painful gallstones, usually with a hospital stay of just one or two days.
Hernia Repair
Open or laparoscopic repair of groin, navel and incisional hernias, including hernias that appear through an old surgical scar.
Frequently Asked Questions
Common questions patients and families ask us about laparoscopic hysterectomy.
Will I go into menopause after a hysterectomy?
Not if your ovaries are kept. Your periods will stop, but the ovaries continue to make hormones until your natural menopause. If the ovaries are removed before menopause, menopausal symptoms can start within days, and your doctor will discuss treatment options with you.
Will my ovaries be removed?
Not always; it depends on your age and condition. In women who have not reached menopause, healthy ovaries are usually kept. Removal may be advised if the ovaries are diseased, there is a high risk of ovarian cancer, or you are around or past menopause. This is decided together with you before surgery.
Is laparoscopic hysterectomy safer than open surgery?
In suitable patients it is safe and has clear advantages over open surgery — less pain, less blood loss, fewer wound infections, a shorter hospital stay and a faster recovery. Not every woman is suitable; a very large uterus or suspected cancer may need a different approach.
How painful is it, and how big are the scars?
There are three or four small cuts of about 5–10 mm, which fade to faint marks over the following months. Most women need regular pain tablets for only a few days. Shoulder-tip pain from the gas is common in the first day or two and settles on its own.
Will a hysterectomy affect my married life?
Once healed, most women return to a normal sexual life, and many find it better because the pain and heavy bleeding are gone. Wait about 6 weeks, until your doctor confirms that the top of the vagina has healed.
Will I gain weight or feel weak after the operation?
Removing the uterus does not itself cause weight gain or lasting weakness. Tiredness in the first few weeks is normal while the body heals, and once anaemia is corrected many women feel more energetic than before. Stay active and eat a balanced diet.
Do I still need Pap smears after a hysterectomy?
If the cervix was removed for a non-cancerous reason and your previous smears were normal, routine Pap smears are usually no longer needed. If the cervix was kept, or you have had pre-cancerous changes, continue screening as your gynaecologist advises.
Can fibroids come back after a hysterectomy?
No. Once the uterus is removed, fibroids of the uterus cannot return and periods stop permanently. This is one reason women whose family is complete may choose a hysterectomy over a myomectomy, after which new fibroids can grow.
How much does laparoscopic hysterectomy cost, and is it covered by insurance?
The cost depends on the type of hysterectomy, your other health conditions and the length of stay. Our team gives a written estimate before surgery. SKS Hospital is empanelled with major insurers and TPAs, and hysterectomy for a medical reason is usually covered — our insurance desk helps with pre-authorisation.
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