What happens on the day of a laparoscopic hysterectomy?

Medically reviewed by our consultant obstetrician & gynaecologist (MBBS, MS OBG). Last reviewed: 29 October 2026.

What does "TLH" mean on my admission papers?

"TLH" stands for total laparoscopic hysterectomy. It means the womb and the neck of the womb (cervix) are removed through small keyhole cuts. What a hysterectomy is, why it may be advised and how the different routes compare are explained in our hysterectomy overview.

This guide walks you through the day of the operation itself, step by step.

What should I do before I come in?

Your team will give you clear written instructions. In general, they cover three things.

• Fasting: you will be asked to stop eating some hours before the operation, often about six. Water or other clear fluids may be allowed until about two hours before. Your team will tell you the exact times. An empty stomach keeps you safe under anaesthesia, so please follow them closely.
• Medicines: bring all your usual tablets in their boxes. Some, such as blood thinners or diabetes medicines, may need to be paused or changed. Do this only as your doctor advises.
• What to bring: your reports, a loose nightdress, sanitary pads, slippers and a family member or friend to stay with you.

Please remove nail polish, jewellery and contact lenses before you arrive. Tell the team straight away if you have a cold, fever or any new illness.

What happens when I arrive at the hospital?

You are admitted to the ward on the morning of the operation, or sometimes the evening before. A nurse checks your blood pressure, pulse, temperature and weight. If you could be pregnant, a simple urine pregnancy test is usually done that morning. Your name and the planned operation are confirmed, often more than once. This repetition is a safety habit, not a sign that anything is wrong.

You change into a hospital gown. A small plastic tube (cannula) is placed in a vein on your hand or arm. This is later used for the drip and medicines. You may be given special stockings to help the blood flow in your legs. Some women also get a small daily injection to prevent clots, starting after the operation.

What will I be asked to sign?

Before any operation, you sign a consent form. Your doctor goes over it with you first. It records the operation planned, the reasons for it, and the possible risks, such as bleeding, infection or injury to nearby organs like the bladder, the bowel or the tubes that drain the kidneys. Rarely, the operation may need to be changed to a larger cut on the tummy to finish it safely; this is also on the consent form. These risks are uncommon, but you have a right to know about them.

The form also records whether your ovaries and tubes are to be removed or kept. This is decided with you beforehand. The consent form also records what you would want if something unexpected is found. Take your time. Ask anything that is unclear. Nothing goes ahead until you are comfortable with the plan.

When will I meet the anaesthetist?

The anaesthetist sees you on the ward before the operation. They check your health, allergies and when you last ate and drank. Share any worries about going to sleep then. What the anaesthesia involves is explained in our guide to anaesthesia during gynaecological surgery.

What happens in the operating theatre before the surgery starts?

You are wheeled or walked into the theatre. Stickers go on your chest, a cuff on your arm and a clip on your finger. Medicine is given through the cannula and you go to sleep. Once you are asleep, a thin soft tube (catheter) is placed in the bladder to drain urine.

How does the surgeon see inside through small cuts?

Here it is in plain words. A small cut is made in or near the navel. The tummy is gently filled with carbon dioxide gas. This lifts the tummy wall away from the organs, like a tent, so there is room to see and work.

A thin telescope with a camera is passed through this cut. It shows a clear, magnified picture on a screen. Two or three more small cuts, usually lower down, are used for slim instruments. For a hysterectomy there is usually one more cut than for smaller keyhole operations. These openings are called "ports". Each is usually about half a centimetre to a centimetre long.

How is the womb removed in a keyhole hysterectomy?

Using the camera and fine instruments, the surgeon carefully separates the womb from the structures that hold it in place. Its blood vessels are sealed as the surgeon goes, to keep bleeding low. If the ovaries and tubes are to be kept, they are gently separated and left in place.

Once the womb is fully detached, it is usually taken out through the vagina. This is why no large cut on the tummy is needed. The upper end of the vagina is then closed with dissolving stitches. If the womb is large, it may need to be brought out in smaller pieces or through a slightly bigger cut. Your doctor will explain this beforehand if it applies to you.

At the end, the gas is let out and the small cuts are closed, often with dissolving stitches and small dressings. The operation often takes around one to two hours, though this varies from woman to woman.

What will I feel when I wake up?

You wake up in the recovery area, where a nurse stays close by. You may feel drowsy or a little cold. If a breathing tube was used, it is removed as you wake up; a sore or dry throat for a day is common. Some women feel sick for a while; medicine can help with this.

You will notice a drip in your arm, giving fluids and pain relief, and the catheter draining urine. Some tummy discomfort is expected. Many women also feel an ache in the shoulder tip. This comes from the gas used during surgery and usually settles within a few days. Please tell the nurses about any pain; it is much easier to control early.

A little vaginal bleeding or spotting is normal after a hysterectomy. You will be wearing a pad.

When can I eat, drink and walk again?

Once you are awake and not feeling sick, you can usually start with sips of water, then light food later the same day. The catheter is often removed later that day or the next morning.

You will be encouraged to sit up and walk a few steps, with help, on the same day or the next morning. Walking early really matters. It eases wind pain, helps your bowels and bladder work again, and lowers the risk of clots in the legs.

How long will I stay in hospital?

Most women stay a day or two after a laparoscopic hysterectomy. Some go home the same day, if they are well. You can go home when you are eating, drinking and passing urine on your own, walking comfortably, and your pain is controlled with tablets. Before you leave, you will be given your medicines, advice on caring for the small cuts, and a follow-up date.

The weeks at home, such as rest, lifting, bathing, work and when to return to normal life, are covered in our guide to keyhole surgery recovery. Please call us straight away if you have heavy bleeding, fever, worsening pain, trouble passing urine, breathlessness or chest pain after you go home. Also call if you notice pain or swelling in a calf, a smelly vaginal discharge, or redness or pus at the cuts.

Where is a laparoscopic hysterectomy done?

This guide is by the Pai Hospital Team. A laparoscopic hysterectomy is done only at Pai Hospital in Vasco, which has its own operating theatre. Consultations before and after surgery are also available at our consultation points in Panjim, Margao and Mapusa. Our doctors will explain the reason for your operation, the route chosen and what the day will look like for you.

For questions, message us on WhatsApp at +91 77989 73345. Consultations are by appointment; to book one, call +91 77989 73345, or +91 95459 20817, or +91 75582 52088. This article is for education only and is not personal medical advice; please speak to your doctor about your own situation.

What else do women ask about the day of a laparoscopic hysterectomy?

Or call +91 95459 20817 · +91 75582 52088 · 0832 251 3641

This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.