Ioannis K. Raptis is an accredited physician (MIC II qualification) certified by the German Society for Gynecological Endoscopy (AGE) to perform advanced laparoscopic and hysteroscopic procedures of high complexity.
Ioannis K. Raptis is an accredited physician (MIC II qualification) certified by the German Society for Gynecological Endoscopy (AGE) to perform advanced laparoscopic and hysteroscopic procedures of high complexity.
Follow Us
Hysterectomy is the surgical removal of the uterus in order to treat a gynecological condition. With the removal of the organ, menstruation stops and the woman is no longer able to become pregnant. However, no hormonal changes occur, as the ovaries—which produce female hormones—are not affected.
Depending on the condition, the appropriate type of hysterectomy is selected, and a decision is made regarding whether the ovaries will be preserved.
In a subtotal (supracervical) hysterectomy, only the body of the uterus is removed, while the cervix remains intact. A common indication for this procedure is the presence of multiple large fibroids in women who have completed their family planning.
In a total hysterectomy, the entire uterus is removed. Conditions in which this procedure is performed include persistent bleeding and atypical endometrial hyperplasia.
Finally, in a radical hysterectomy, both the uterus and the surrounding tissues are removed, as in cases of malignancy.
Taking into account the patient’s age, reproductive plans, medical history, and the severity of the condition, hysterectomy may be recommended as a treatment for the following gynecological problems:
In the laparoscopic approach, the procedure is performed through small incisions using an endoscope, thereby avoiding an open abdominal incision and its associated complications. This method maximizes surgical precision while minimizing the burden on the patient, ensuring faster recovery, little to no postoperative pain, minimal risk of complications, and excellent aesthetic results.
Painless laparoscopic hysterectomy Sans douleur
represents a further step toward minimizing postoperative pain. It combines modern surgical techniques with appropriate general and local anesthesia, allowing the patient to return home on the same day.
The tests required prior to a laparoscopic hysterectomy depend on the underlying condition. In the majority of cases, a transvaginal uterine ultrasound and preoperative evaluation at the clinic a few days before the procedure are sufficient for surgery to proceed.
Laparoscopic hysterectomies performed by experienced surgeons are characterized by rapid recovery. The patient may return home on the same or the following day after surgery and resume her daily activities 3–4 days later.
There are, of course, exceptions, such as in urogynecological vaginal suspension procedures and in cases of malignancy, where avoidance of physical exertion for a longer period may be recommended.
Regarding sexual intercourse, it may be resumed after a few days in cases of subtotal hysterectomy and after three months in cases of total hysterectomy, without any change in its quality.
A hysterectomy does not necessarily negatively affect sexual function. In many cases, sexual well-being may improve, particularly due to relief from chronic pain or heavy bleeding. However, individual experiences may vary depending on the type of surgery and whether the ovaries are preserved.
Recovery after a laparoscopic hysterectomy is generally faster than after open surgery, thanks to the small incisions and reduced surgical trauma. Patients may be able to resume light daily activities within 3–4 days, although full recovery typically takes several weeks.
A hysterectomy is performed not only to treat malignant conditions but also certain benign gynecological conditions, such as uterine fibroids, uterine prolapse, and endometrial hyperplasia, particularly when they cause severe symptoms or when other treatment options are unsuitable or ineffective.
In a subtotal hysterectomy, the body of the uterus is removed, while the cervix is preserved. In contrast, a total hysterectomy involves the removal of both the body of the uterus and the cervix. The choice of the most appropriate procedure depends on the gynecological condition, the patient’s medical history, and her individual needs. It is important to note that removing the uterus does not necessarily involve removing the ovaries, which can be preserved if there is no medical indication for their removal.
Laparoscopic hysterectomy is performed through small incisions in the abdomen, minimizing tissue trauma. Compared to open surgery, it generally offers less postoperative pain, a shorter hospital stay, faster recovery, and better cosmetic results. Additionally, it reduces the risk of certain postoperative complications, such as surgical wound infections, although it does not eliminate the risks associated with any surgical procedure.
The Sans Douleur technique combines advanced laparoscopic surgical techniques with appropriate general and local anesthesia protocols used in vaginal hysterectomy, aiming to minimize postoperative pain and promote earlier mobilization of the patient. In selected cases, this approach allows the patient to safely return home on the same day as the procedure, provided that the necessary postoperative recovery and safety criteria are met.
Before a laparoscopic hysterectomy, a transvaginal ultrasound of the uterus and adnexa is usually performed, along with the necessary preoperative laboratory tests and anesthetic assessment. Depending on the gynecological condition and the patient’s medical history, the gynecologist may recommend additional examinations, such as a pelvic MRI, hysteroscopy, or endometrial biopsy when clinically indicated, to ensure proper and safe surgical planning.
