CPT® Code 58543

Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive surgical procedure designed to remove the uterus while preserving the cervix. This approach serves as an alternative to the more traditional total abdominal hysterectomy. One of the key advantages of LSH is that it maintains better pelvic support, as the ligaments that support the vagina and cervix remain intact. This preservation is significant for patients, as it can help maintain sexual function by keeping the cervix and its associated secretory glands. It is important to note that LSH is not indicated for patients with cancer or those who have a history of precancerous cervical conditions. During the procedure, a retractor is inserted vaginally into the cervix to facilitate visualization and manipulation of the uterus. The surgical process involves making a small incision at the belly button and two additional small incisions near the hip bones to accommodate laparoscopic instruments. The abdomen is inflated with carbon dioxide gas to create a working space for the surgeon. A laparoscope is introduced through the belly button incision, while cutting and grasping instruments, along with the retractor, are utilized through the other incisions. The uterus, either alone or in conjunction with the fallopian tubes and/or ovaries, is carefully separated from its blood supply and detached from the cervix. To enhance support and reduce the risk of future prolapse, permanent sutures are placed in the ligaments that support the cervix. The center of the cervix is then coagulated to minimize bleeding, and the cervix is covered with peritoneum, the abdominal lining. Following this, a morcellator—a specialized instrument with a rounded blade—is used to deliver the uterus, either with or without the tubes and/or ovaries, in strips for pathological examination. After addressing any bleeding points, the instruments are removed, and the carbon dioxide gas is evacuated from the abdomen before the incisions are closed.