Dr. Georges Akl is a Physician, Founder, and Chairman of the Gynecology Department of the Omni Surgery Center in Utica, NY. In the following article, Georges Akl, M.D. discusses the feasibility and safety of laparoscopic hysterectomies as an outpatient procedure, and why this technique is most preferred by physicians and patients alike. Hysterectomies are one of the most common surgeries performed in North America, and they can be done several ways - laparoscopic, vaginal, or abdominal. Georges Akl M.D. explains that total laparoscopic hysterectomies (TLHs) can be performed as outpatient procedures without compromising the safety of the patient. Readmission rates after three months occur at the same frequency for both inpatient and outpatient procedures, and it is a safe option even for patients with minor, pre-surgical complications. When compared to traditional abdominal hysterectomies, patients that receive a TLH recover faster, have a lower risk of post-surgical complications, and experience less pain and scarring. Below, Dr. Georges Akl takes a look at the success of this outpatient procedure in more detail.

Georges Akl M.D. Discusses TLH as a Successful Outpatient Procedure

Dr. Georges Akl Laparoscopic hysterectomies are just one option for minimally invasive hysterectomies (vaginal surgery is the other). Traditionally, these surgeries were done as inpatient procedures, and although they have become more common ambulatory procedures in recent years. However, patient fears around same-day discharge continue to raise the question of the safety of these procedures in an outpatient setting.

Can This Really Be Done in an Outpatient Setting?

Georges Akl of New York says that total laparoscopic hysterectomies are absolutely doable as outpatient procedures. In fact, it is preferable for these surgeries to be done in outpatient, rather than inpatient settings. A laparoscopic hysterectomy will take the same amount of time as an abdominal hysterectomy, and at only 1.5-2 hours, it is entirely realistic for a woman to receive a TLH and go home on the same day.

But is it Really Safe?

Although an outpatient TLH will not be a safe option for every single patient, it is a viable and low-risk procedure for patients that meet the criteria. In the absence of complications during surgery, patients that undergo a TLH could possibly be readmitted at the same rate as those that received inpatient care after surgery at the three-month benchmark. Dr. Georges Akl explains that during the three-day post-surgical period, there is a minimal readmission rate for patients recovering at home. This is the case even when pre-operative complications such as endometriosis, adhesions, etc. were present.

Abdominal vs. Laparoscopic Hysterectomy

Before laparoscopic surgery became a viable option in the field, hysterectomies were performed through an abdominal incision. Since laparoscopic procedures have become more common, a number of benefits of this minimally invasive approach have been recognized:

• Faster Recovery

After an abdominal hysterectomy, patients are required to stay in the hospital for 2-3 days to recover, and after they are sent home, it will be another 4-6 weeks until they have healed fully and can return to all their normal, daily functions. Georges Akl of New York notes that with laparoscopic surgery, the patient can safely go home the same day, and their total recovery time will be only 1-2 weeks. This procedure creates multiple small incisions rather than one large incision, leaving the body with less healing and scarring.

• Lower Risks

As a minimally invasive surgical option, TLH is associated with less bleeding and a lower rate of infection. With several small incision sites, there is much less opportunity for blood loss to occur during surgery and less opportunity for harmful pathogens to infect the surgical site.

• Less Pain and Scarring

Dr. Georges Akl reports that patients that receive a laparoscopic hysterectomy will experience much less scarring and reportedly, less pain after surgery when compared to patients that undergo an abdominal hysterectomy. As mentioned above, the smaller incisions promote the exterior tissue to heal better and produce less scarring.

Final Thoughts

All in all, Dr. Georges Akl says that a total laparoscopic hysterectomy surgery is entirely feasible as an outpatient procedure. It carries no greater risk for readmissions than procedures, and it comes with a long list of benefits over traditional abdominal surgeries. As physicians continue to improve their expertise and technology continues to advance, outpatient TLHs will become an even better option for the women who need them.