Total Laparoscopic Hysterectomy and Bilateral Salpingo-Oophorectomy (
The role of laparoscopy total hysterectomy in performing a salpingo oophorectomy with hysterectomy has dramatically expanded in recent years but has come under increasing scrutiny regarding its benefits in certain clinical settings and its overall cost-effectiveness. A TLH is substitute for laparoscopic-assisted vaginal hysterectomy (LAVH) and substitute for a vaginal hysterectomy. As a surgeon develops expertise and experience with laparoscopic technique, the number of patients for whom he or she offers a laparoscopic approach increases. Other patients will have pathology or coexisting abnormalities that require an abdominal incision. The laparoscope therefore substitute the vaginal hysterectomy and avoids an abdominal incision when suspected or uncertain adnexal pathology or adhesive disease might otherwise preclude a strictly vaginal approach. The visualization provided allows for dissection and removal of the adnexa and the release of any adhesive disease. If no pathology exists that requires operative laparoscopy, then a simple vaginal hysterectomy is performed.