Laparoscopic Hysterectomy: Why It Is Done, What Happens and How Recovery Goes
Being told you may need a hysterectomy, an operation to remove the uterus (womb), can feel overwhelming. Many women have questions:
Is it really necessary?
Can it be done by keyhole surgery?
How long will recovery take?
This guide explains the common reasons, the types of hysterectomy, what laparoscopic surgery involves and what to expect afterwards. It cannot replace a consultation. Your gynaecologist will advise you based on your own health.
Why might a hysterectomy be advised?
A hysterectomy is a major decision and is usually considered after other treatments have been discussed or tried. Common reasons include:
Uterine fibroids that cause heavy bleeding, pain or pressure, where medicines or myomectomy (removal of fibroids only) are not suitable
Abnormal or heavy uterine bleeding that does not respond to other treatment
Adenomyosis, where the lining of the womb grows into its muscle wall and causes painful, heavy periods
Endometriosis, in selected severe cases
Uterine prolapse, where the womb slips down into the vagina
Pre-cancerous changes or cancer of the uterus, cervix or ovaries. Here a gynaecological oncology opinion is part of the plan.
If you still wish to become pregnant, tell your doctor. Many conditions, including most fibroids, can be treated in ways that keep the uterus. Read more about fibroid treatment.
Types of hysterectomy
By what is removed:
Total hysterectomy: the uterus and cervix are removed. This is the most common type.
Subtotal hysterectomy: the uterus is removed but the cervix is left.
Hysterectomy with salpingo-oophorectomy: the fallopian tubes and/or ovaries are also removed. Whether the ovaries are kept depends on your age, your risk factors and the reason for surgery.
Radical hysterectomy: a wider operation used for certain cancers.
By how it is done:
Abdominal (open) hysterectomy: through a cut in the lower abdomen.
Vaginal hysterectomy: through the vagina, with no abdominal cut. This is often used for prolapse.
Laparoscopic hysterectomy (TLH or LAVH): through small keyhole cuts, using a camera and fine instruments.
Robotic-assisted hysterectomy: a form of laparoscopic surgery in which the surgeon controls robotic instruments.
What is laparoscopic hysterectomy?
In a laparoscopic hysterectomy, the surgeon makes three or four small cuts in the abdomen, each usually 5–10 mm. A thin telescope with a camera (laparoscope) shows a magnified view on a screen. The uterus is freed from its attachments and removed, usually through the vagina. The operation is done under general anaesthesia.
Possible advantages, compared with open surgery, for suitable patients:
Smaller scars
Less pain after the operation
A shorter hospital stay
An earlier return to daily activities
Not every patient is suitable. A very large uterus, extensive scar tissue from previous surgery, or some cancers may make open or vaginal surgery a better choice. Your gynaecologist will explain why a particular approach is recommended for you.
Before surgery
Your gynaecologist will usually advise:
Tests: blood tests, an ultrasound or MRI of the pelvis, a Pap smear if due, and sometimes an endometrial biopsy
Fitness checks: for anaesthesia, including ECG and other tests depending on your age and health
A medicine review: especially blood thinners, diabetes and blood-pressure medicines
A discussion of consent: benefits, risks and alternatives, and whether the ovaries and tubes will be removed
Risks to know about
Laparoscopic hysterectomy is a commonly performed operation, but like any surgery it carries risks. These include:
Bleeding, infection, and blood clots in the legs or lungs
Injury to nearby organs such as the bladder, ureters or bowel
Reactions to anaesthesia
The occasional need to convert to open surgery during the operation
Your surgical team takes steps to reduce these risks and will explain how they apply to you.
Recovery after laparoscopic hysterectomy
Recovery differs from person to person. A general guide:
Day 0–2: Many women go home within one to two days. You may have mild abdominal pain, shoulder-tip pain from the gas used during surgery, and light vaginal spotting. Walking early helps prevent clots.
Week 1–2: Gentle activity at home. Short walks are encouraged. Avoid lifting anything heavy. Pain usually settles with prescribed medicines.
Week 2–4: Many women with desk jobs return to work, depending on how they feel and on their doctor's advice.
Week 4–6: Gradual return to most activities. Avoid heavy lifting, strenuous exercise and sexual intercourse until your doctor confirms the vaginal vault has healed, usually around six weeks.
Contact your doctor if you have a fever, heavy bleeding, foul-smelling discharge, increasing abdominal pain, pain or swelling in a leg, or difficulty passing urine.
Life after hysterectomy
Periods: after a hysterectomy you will no longer have periods and cannot become pregnant.
If the ovaries are kept: they usually continue to produce hormones.
If the ovaries are removed before menopause: menopausal symptoms may start, and your doctor will discuss how to manage them.
Wellbeing: many women find that symptoms such as heavy bleeding or pain improve. Talk to your gynaecologist about any emotional or physical concerns.
Questions to ask your gynaecologist
Why do you recommend a hysterectomy for me, and what are the alternatives?
Am I suitable for laparoscopic or vaginal surgery?
Will my ovaries and tubes be removed?
How long will I stay in hospital, and when can I return to work?
What will it cost, and is it covered by my insurance?
Gynaecology at THE CLINICS, South Delhi
Gynaecology consultations, ultrasound and ultrasound-guided procedures take place at the women's clinic at THE CLINICS, Green Park, where Dr Niti Vijay (DMC Reg. No. 6333) sees patients for gynaecology, IVF and cosmetic gynaecology. Laparoscopic and other gynaecological surgery, when advised, is done at THE CLINICS MISC, Hauz Khas. THE CLINICS MISC Hauz Khas is a six-bed surgical facility with a four-bed HDU and two private rooms, all with ICU-enabled beds, a modular operation theatre, laser systems, a 4K HD laparoscopic system and a dedicated surgical team. OPD hours at both branches are 9 am to 9 pm.
The team sees women with fibroids, heavy bleeding, endometriosis, prolapse and other conditions. Learn more on our gynaecology page and fibroid treatment page, or read about endometriosis. Any cost estimate is shared after examination.
To book, call or WhatsApp +91 9217381353 or book a consultation online.
This article was prepared with AI assistance. Medically reviewed by Dr Saurabh Bansal (Delhi Medical Council Reg. No. 37887). It is for general information and is not a substitute for medical advice. Treatment decisions should be made with your doctor after an examination.
