LASH – laparascopic supracervical hysterectomy

Laparoscopic Supracervical Hysterectomy (LSH) is a much less invasive procedure than either abdominal or vaginal hysterectomy that leaves the cervix and its mucous glands in place thus avoiding vaginal dryness which can be one of the most common complaints that women have post hysterectomy. It is thought that the cervix may play a more significant part in women’s experiences of orgasm and sex post hysterectomy than had previously been thought.

Laparascopic supracervical hysterectomy is performed by doing much of the surgical procedure via three cuts in the abdomen, including one in the belly button and two on either side of it. During the operation surgical instruments and cameras are placed in the abdominal cavity thus allowing the surgeon to view what is being done. This allows the surgeon to detach the uterus from the internal musculature and from the cervix as well, they are then able to remove it through the small incisions made in the abdomen.

Due to it’s minimally invasive nature, recovery is quicker than for an abdominal procedure but maybe not as quick as for a vaginal hysterectomy. However, there are few surgeons available that have been trained in this procedure and it may not be suitable for all women so a discussion needs to take place with your gynaecologist.

Leave a Reply


  1. Hi there – I had this procedure in 04/2015 and was wondering if you still experience any minor bleeding monthly (1-3 days with minor bleeding or spotting?)


  2. I had this operation on the NHS via NHS Grampian. Its been nearly 3 weeks. Apart from general feelings of bloating I think it went well. Again, you think you are okay etc but it is easy to over do things. You need to listen to your body

  3. Dear Mandee

    You need someone that specialises in endometriosis as well as LASH, there is not too many around. If you are interested I carry out these surgeries at our Accredited Centre for severe endometriosis at Northwick Park Hospital.

  4. hi all im looking for advise im 32 and having to have this procedure done as they cant control my bleeding (which is at flooding point for atleast 3 weeks of every month.

    what do i need to take in with my after the operation im having it done on monday 30th November?

  5. Dear All

    There are lots of benefits for LASH over other types of Laparoscopic hysterectomies. LASH should be considered as the least invasive form of any kind of hysterectomy including total Laparoscopic hysterectomies (TLH) and Assisted vaginal hysterectomies (LAVH).
    It is considered to be a “day care” procedure and women can go home on the same day or on the following day.
    It definitely requires an advanced laparoscopic surgeon to perform it and I have actually been performing this procedure since 2007/2008 over eight years both at the NHS and Privately.
    I would recommended to all women with adenomyosis, endometriosis, fibroids, and the rest of women with benign disease requiring hysterectomy.
    I would not recommended it if the indication for the hysterectomy is endometrial cancer or when if there was previous abnormal cervical smear within the past 10 years,
    Women who would have LASH will need to continue with their cervical smears.
    Mr Kamal Shehata-Iskander, Consultant Laparoscopic Surgeon

  6. Hi,
    I’d like to share my experience here as I too have just had this type of hysterectomy and, if a suitably experienced surgeon can be found, I would highly recommend it.
    I’m an Englishwoman living in Oregon, USA, so some aspects of experience will be slightly different; if anything I had too many surgeons to choose from as I live in a city with a number of large medical facilities, but finding someone I trusted and who was right for the job was crucial. The reduced recovery time was a huge influence on my decision to have the laprascopic surgery, with robot assist, rather than by a more traditional transverse incision. My personal physiology meant I had to have the uterus etc removed through an small incision on my mid-line rather than vaginally, which further reduced the pool of surgeons available to me, but I found that once I was on the books with one surgeon she was happy to refer me to a college who was more experienced in the type of surgery I required. This cross-referral is also something I’ve come across with the NHS in London.
    It has now been eight days since my procedure and I feel very good. I was discharged from hospital after 24 hours and though I came home on a bucket load of pain meds (diclofenac and oxycodone) I have managed to taper my meds dramatically in that time so I’m no longer taking much more than I would have taken pre-op for my worst period days. I had 1-2-1 help at home from my partner for the first 5 days after hospital and this is very important because though I was itching to get moving about I quickly found that didn’t want to lift anything heavier than a mug of tea for the first week.
    The surgery left me with four small incisions, 1-2 cm (from the robot) and one larger lateral one (4-5 cm) above my belly button. The steristrips on the large incision came off yesterday and it seems to be healing well (though it is quite itchy).
    The best advice my surgeon gave me was listen to your body, but err on the side of caution; it’s the little things that get you, opening a heavy shop door, navigating yourself down a moving train, even walking up a small light of stairs in a bookshop! I’ll admit I overdid it a bit yesterday by going downtown for several hours and then going out again later for dinner, so I am having a day of bed rest today to let everything settle back down, but I expect to be going out for shorter daily trips again from tomorrow and I hope to get back at my part time job as a maths tutor in a couple of weeks time.
    Be well.

  7. I have alot of adhesions from past surgeries and widespread endometriosis. Is lash an option for me?

  8. Does anyone know of a consultant that specialises in carrying out a LASH in Sheffield, chesterfield or south yorkshire. Preferably on the NHS.

  9. Hi Clare,

    So – what did you decide in the end? My case is a bit like yours, in that the motivation is PMDD, so I just want to get rid of periods and all the cyclic phenomena, so was going to go for a LSH, but am worried keeping a cervix makes mini bleeds which might be bad news.

    Hope everything worked out for you….


  10. Hi Lucy
    I had a LASH nearly 2 years ago at 43.
    I have never had a ‘mini bleed’ since then and a period-free life is fantastic!

    I didn’t get even the tiniest bit of bleeding for the first few weeks and all the sanitary towels I bought for post-op were never used!
    I then started with a pinkish watery bleeding about 3 weeks after the op and thought I was just one of the unlucky ones who was going to have mini bleeds. Turns out I had an infection in the pelvic cavity, which I didn’t find out about for several weeks. I got put on antibiotics – but if I’d known it was an infection I would have liked to have got it sorted much sooner.

    My advice is to go to the GP if you have any bleeding or feel unwell – as it may be a simple infection that you can have a dose of antibiotics for straight away.

    By the way – I’m back to a full, active life – including running/gym most days and feel great.
    I haven’t had any signs of an early menopause yet, either!

    All the best


  11. Hi Jo, the swelling is normal for every hysterectomy and will take a few months to reduce and it’s not unusual to have extreme fatigue afterwards as well … 🙂

  12. I had a LSH on the 8 th of may, the operation ran into comicationas as my womb was 4 times the size it should have been , surgeon struggled to remove it and the op took over 5 hours an i ran into breathing dificulties and finished up on hdu, 3 weeks later im still struggling to walk and have qlot of swelling around my tummy button, im slightly disheartened as i thought i would be feeling better by now. I had the op because of fibroids an an elarged twisted womb, which made me have constant extreme bleeding, i had a failed procedure in january which made my condition worse an have been virtually housebound since, which is probably why i am desperate to be back on my feet

  13. This often happens and it can start at 2 months post op and is related to the healing that takes place.

  14. Hello could you tell me if there is any bleeding (through the vagina) directly after a Laparoscopic supracervical hysterectomy?
    Many thanks

  15. I needed some opinions/advice from women who have fibroids and who have gone through with this sort of procedure after birth so that I am fully informed of options before approaching my GP or Gynaecologist. I will of course be taking their advice on board. I am due to see my obstetrician in 3 weeks time to broach the subject but wanted to do some research myself.
    Any advice is greatly appreciated.

  16. Hi Suzy, I’d be very surprised if your GP actually agreed to recommend this for you. I guess you will need to go back and have a chat to see what they think.

  17. Hi I am currently 17 wks pregnant with 2nd child. I have long medical history of multiple fibroids – had myomectomy in 1998 to remove 10, then used mirena coil for 5 years (which was fab – normal periods) but once mirena coil had to come out the fibroid grew back with a vengence. Had awful 1st pregnancy – very quick & painless labour/delivery (yey!) but took a long time to recover after the birth. I was wondering what people thought about having a Lap hysterectomy (keeping ovaries & cervix) immediately following birth?

    I am 40, fairly fit and I don’t want anymore children but don’t want to go through menopause early. I’m wondering about recovery time etc. Should I get it done sooner whilst the little one is tiny rather than waiting until little one is running about ?
    advice would be greatly appreciated. xxx

  18. An update…on 4/4/11 i had my LSH+BSO in my local nhs hospital and was home the very next day on just voltarol and paracetamol and moving around relatively well. Only real discomfort was on getting on and off bed from lying, but ‘discomfort’, not ‘pain’. Had 2 x glued ports in left side of belly ( less than a cm ), glued port in belly button and 2cm stitched cut on bikini line. There are no internal stitches as all is cauterised as removed. I am fortunate enough, unlike many other women 🙁 ,not to have had other complications iro fibroids or endo and the recovery is just amazingly quick. I was spending afternoons shopping easily by week 3,full days out and about and driving by week 4 and at my post op appt at 7 wks+1 recently, was told i can do ‘anything’ that i did pre-op, including lifting, housework ( groan!!), swimming, gardening,cycling…”ANYTHING”. I was regularly reminded to take it easy, and had help with kids from mum for 4 weeks,but after week 3, NOTHING gave any discomfort. Its trully outstanding and my surgeon is my hero!! EVERYONE should have this as an option if the physicality of their condition allows. IF you are able to find a laparoscopic specialist ( wld recommend Mr Eskander in North Devon ) and are suitable, do NOT settle for abdominal surgery just because it is quicker ( laparo is around 2-3 hrs ) and cheaper , as my previous gynae openly told me 2 yrs ago, before my local nhs hospital started offering laparoscopic ops , cutting their costs by ‘sharing’ the morcellator between other hospitals. Simply astounding in terms of the speed of recovery….especially for an overweight and not particularly fit 43 yr old patient. More surgeons need training in this method. It may not be suitable for all women, and my surgeon prefers to keep the cervix ( if no abnormal smears ) due to reduced risk then of accidental damage to bladder+bowel, but in lost work hours alone it must be worth it in the long run!!

  19. Gloopy is a nice medical term isn’t it 🙂 There is no normal as such and different surgeons will have different practices according to their training. The most common is three incisions but this is just ‘the most common’.

  20. HI I have had a LASH – both ovaries removed but cervix left. I see from your description it should be 3 incisions but I’ve ended up with 4. One in belly button, one either side and a 1.5 inch cut in pubic area. Not yet seen consultant but wondered if this was normal. Consultant said my uterus was “gloopy” upon removal so wondered if this had anything to do with it? I’m 25 days post op. Thanks. This is the one cut that is still really painful to be honest, caught scab yesterday and it started to bleed a bit. Ouch! thanks

  21. The week before Christmas I went into Blackheath Hospital, London for a laparoscopy to check it wasn’t cancer, £3347.00 and a follow up appointment £195. They have an all-inclusive package so if something goes wrong or you have to stay in longer than expected there is no extra cost! 22nd January I then had a subtotal laparoscopic hysterectomy (kept ovaries and cervix) £3577.00 plus two follow up appointments at £195 each time. I have to go back again in May for a final check which will be another £195. It may not be necessary to have the first operation if you are sure the growths are not cancerous.
    I had a polyp across the cervix, another large polyp inside the uterus and a very large growth outside the uterus which was bigger than my uterus. I have seen it as the surgeon videoed the operation for teaching purposes because the operation was complicated!! I had no symptoms at all except I was suffering with antacid stomach problems; the horrors were found when I had a CT scan. However, since the operation I no longer have backache which I had put down to years of sport and I urinate far less than I did before. I still have the antacid issue but far less severe.
    He told me he would attempt the operation by keyhole but may have to open me up during the operation if he couldn’t manage it. The video shows him removing the growth outside of the uterus first using a morcellator; this took some time as it was big and was resting on my lower bowel and urinary tubes. He then removed the uterus. After the operation he said he only just managed it, the worry was damaging my urinary tubes. I had the operation on Saturday morning and went home on Sunday afternoon.
    I was back at work in week five; I am a self-employed education consultant dealing with schools in difficulty so my job is stressful and I work long hours. I went back 3 days a week for two weeks and then full time. The only thing I noticed was reduced stamina levels and a bit of soreness on my left side where the morcellator went in. 9 weeks later I am completely back to normal and feel healthier apart from weight gain from being inactive for a month or so.
    By the way I am 51, menopausal and reasonably fit. Ring Dr Patwardhan, as I said before I really rated this man and I have heard of so many people being pushed into non laparoscopic surgery. Aside from the worry of not being able to work for months I was worried about coping emotionally doing nothing. I am hopeless when it comes to sitting about and get bored very easily.
    Good luck

  22. how much did you pay penny? and how complex was your case? my womb is 5 months with multiple fibroids including pendunculated; Like you recovery time is important to me; my consultant is saying not many surgeons about to do laparascopic with morcellator

  23. It’s unusual to be prescribed progesterone especially if the ovaries are being removed and it might be worth chatting with your GP again. Mini bleeds are more common that you might think post hysterectomy and are just usually a light smearing.

  24. I am due to have a LSH+BSO in april for PMDD. The surgeons preference is to retain the cervix as i have never had abnormal smears and do not knowingly suffer with endometriosis, though have a degree of stress incontinence on coughing/sneezing only, after big babies! It has recently been suggested to me that if i retain my cervix, and plan to use oestrogen post op ( i am 43), then i shall also have to use a progestogen and am likely to get mini bleeds. I am now panicking as am intolerant of progestogens ( hence not having just ovaries removed) and had been led to believe that can keep my cervix ( which is cauterized during the op) and will just have to have the 3 yrly cervical smears….they didnt tell me about mini bleeds !! HELP!!!

  25. I had a complicated laprascopic hysterctomy on 22.1.11. I paid for this procedure because I am self employed and it worked out cheaper thn missing work! 7 days on I am amazingly well and could I think, if I took it easy go back to work.
    From what I understand most consultants would not agree to doing such a complex procedure laprascoptically which is why I want to recommend Dr Patwardhan
    This guy is not only skilled at his job but amazingly confident and driven which inspires great confidence. He can bee seen on the NHS but to be honest for the cost, speed and care given, money well spent. More than one person has said to me you wouldn’t think twice about spending the money on a car, which is true!
    Good luck to those about to go through it, if my experience is anthing to go by, it isn’t at all bad.

  26. I would also like to find a good surgeon who could perform this procedure, donot mind if it is private but just want to find the best one in the uk who could do the job, any help would be great thanks

  27. Hi Susan, I’m replying to both your comments here. You need to speak with your GP who should be able to identify the relevant surgeons if any are available in Hampshire and Dorset. You would need to be referred by your GP first anyway as you can’t request an appointment direct even if you are planning to be a private patient. You can use the following website to find people first before talking with your GP:

  28. LASH, how can I find a specialist that carried out this procedure on the NHS in my area (Hampshire/Dorset border BH25) please?
    Your urgent reply would be very much appreciated as I have to make a decision this Thursday.
    Many thanks