Opposite to a Laparoscopic Supracervical Hysterectomy, the Total Laparoscopic Hysterectomy (TLH) involves removal of the uterus and also the cervix*. It is therefore the choice of preserving or removing the cervix that differentiates the TLH from the LSH.
The TLH procedure is started by exposing the uterus and followed by dissecting the ligaments and transecting the blood supply. Hereafter a colpotomy is performed to separate the cervix from the vaginal wall. The uterus needs to be retracted via the vagina or by using a morcellator. The morcellator is used to extract the uterus out from the abdominal cavity.
A morcellator is often used in cases with enlarged uterus. For these cases the LiNA Xcise Morcellator is highly suitable. Lastly, the vaginal vault is sutured laparoscopically and the Total Laparoscopic Hysterectomy is thereby completed.
*The procedure can also include salpingo-oophorectomy (unilateral/bilateral) thereby additionally removing the ovary(-ies) and fallopian tube(s). When performing a radical hysterectomy part of the parametrium is removed as well and in procedures involving cancer there may also be a need for removing the lymp nodes.