Laparo-Endoscopic Single Site (LESS) Hysterectomy

Overview

This minimally-invasive procedure is used to remove a uterus through one small incision in the navel. A LESS hysterectomy has fewer incision sites than traditional open or laparoscopic procedures and will provide a better cosmetic outcome for the patient.

Preparation

Anesthesia is administered, the patient is positioned, and the abdomen is cleaned, sterilized, and inflated with carbon dioxide gas. The gas creates working space for the surgeon's instruments. The surgeon's assistant inserts a uterine manipulator into the vagina, allowing the uterus to be moved and positioned as needed.

Accessing the Abdomen: Traditional and Laparascopic

In a traditional open hysterectomy, the abdomen is accessed through one large incision typically 6-8 inches in length. This is commonly reffered to as a bikini line incision. With a laparoscopic hysterectomy, instead of one large incision, a series of small incisions are made on the abdomen.

Accessing the Abdomen: Single-site Access System

In a LESS hysterectomy, one small incision is created in the navel. The surgery will be performed through a single site access system, rather than through a series of small incisions, or the large incision used in traditional open surgery.

Laparoscope Inserted

The surgeon inserts a laparoscopic camera through one of the ports of the single site access system. This special laparoscope has a deflecting tip that allows the surgeon to have a complete 100° field of view of the surgical site from multiple angles.

Instruments Inserted

Specialized surgical instruments are inserted through the incisions. These instruments are designed for extremely precise movements when guided by the surgeon and can safely and easily grasp, cut, cauterize and remove tissue.

Removing the Reproductive Organs

The surgeon carefully detaches the uterus, cervix, and, if needed, other reproductive organs from the ligaments and structures in the abdomen. The uterus is carefully pulled out of the body through the vagina. Other reproductive structures, such as the fallopian tubes and ovaries, may also be removed. The top of the vagina is then closed with sutures.

End of Procedure and Recovery

After the LESS Hysterectomy, the instruments and the single-site access device are removed. The incision is closed allowing the natural contours of the belly button to hide the surgical incision. The patient may go home the same day or have up to one day stay in the hospital. Recovery time is usually 2-3 weeks, which allows patients to return to normal activity quicker than traditional hysterectomy. Open hysterectomies require a hospital stay of up to five or six days and a recovery of up to six weeks. If your ovaries are also removed, it may lead to symptoms associated with menopause - hot flashes, insomnia, irritability or vaginal dryness. These symptoms may be reduced by alternative therapies. Ask your physician about your options.