Total Laparoscopic Hysterectomy (TLH) with Hernia Repair

This chapter discusses practice of combining hernia repair with total laparoscopic hysterectomy (TLH), an advancement and advantage of minimally invasive surgery (MIS). It mainly focuses on careful preoperative assessment and planning by surgical and gynecological team for proper patient selection, hence ensuring a safe outcome in scenario of two major procedures being carried out simultaneously, decreasing any postoperative infections by vaginal care, antibiotic coverage and preoperative investigations. It also entails that patient recovers from both procedures simultaneously and suffers only one episode of absence from work, not withstanding reducing physical and mental stress to one time only. So this chapter delves into the nuances of preoperative planning and on table precautions and carrying out procedures by both the teams. Additionally, details of the Intraperitoneal Mesh Repair with Primary Closure of the Defect (IPOM Plus) procedure with use of absorbable tack along with laparoscopic hysterectomy is discussed. To conclude, we can say that the goal is not just to perform surgeries but to ensure that patients have a positive and safe experience. As technology advances, this approach to MIS, combines two procedures in the same setting based on surgical expertise and patient-centered care.