Years ago, women with abnormal uterine bleeding, fibroids or other severe gynecological conditions had only one treatment choice: hysterectomy. Now there are many more surgical options that can preserve the uterus, such as endometrial ablation to control abnormal bleeding, or myomectomy or embolization to manage fibroids. But there's still a place for hysterectomy for certain patients, particularly women for whom other treatments have failed.
Nearly 70 percent of the 600,000 hysterectomies performed each year are total abdominal hysterectomies, in which the uterus and the cervix are removed through an abdominal incision. Vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy and laparoscopic hysterectomy (see "Types of Hysterectomy" on page 32) are all less invasive procedures, but they still involve removing the entire uterus. But now, we have the technology to make hysterectomy a safer, less complex, outpatient procedure by removing the uterus laparoscopically and leaving the cervix intact. This procedure, which I began performing in 1990, is called laparoscopic supracervical (also known as subtotal or partial) hysterectomy, or LSH.