Total Laparoscopic Hysterectomy

The applications of minimally invasive pelvic surgery continue to grow. This chapter focuses primarily on the preoperative evaluation, surgical technique and post-operative care of total laparoscopic hysterectomy. Since laparoscopic assisted vaginal hysterectomy is a slight modification of the procedure it is not being discussed separately. The major physiologic obstacles to safe laparoscopy include pregnancy, increased intra cranial pressure, abnormalities of cardiac output and gaseous exchange in the lung, chronic liver diseases and coagulation disorders. In a redo surgery there may be problems of laparoscopic port entry.