A hysterectomy is an operation to remove the womb (uterus). It is considered when heavy bleeding, severe period pain, fibroids, adenomyosis or certain cancers have not responded to other treatments, and when a woman no longer wishes to become pregnant.

A total laparoscopic hysterectomy (TLH) does this through keyhole surgery rather than a large abdominal incision.

What the operation involves

Under general anaesthesia, the surgeon makes about four small incisions in the abdomen. A camera and fine instruments are passed through these, allowing the womb to be detached and removed without opening the abdomen. Because the instruments are small, there is less disturbance to surrounding tissue, less bleeding and less pain afterwards.

Your ovaries are usually left in place. Removing the womb alone does not bring on the menopause. If there is a reason to remove your ovaries as well, your surgeon will discuss it with you beforehand — it is never done without your agreement.

How long you will be in hospital

Most women stay overnight and go home the following day. Some women prefer to go home the same day, and that is possible where recovery is straightforward, but overnight is the usual pattern.

Recovery

You will be encouraged to get up, walk and eat on the day of surgery — early movement helps recovery and reduces the risk of clots. Pain is usually manageable with simple painkillers such as paracetamol for the first few days. There is normally no need for a urinary catheter or a drip beyond the immediate post-operative period.

Take it steadily for the first few weeks: light activity is good, but avoid heavy lifting and strenuous exercise until your surgeon says otherwise. Most women are back to their usual routine, including exercise and sex, within a few weeks. Attend your follow-up appointment so we can confirm you are healing well.

Risks

Like any operation, TLH carries risks: bleeding, infection, injury to the bladder, bowel or ureters, blood clots, and anaesthetic complications. Occasionally keyhole surgery has to be converted to open surgery. These risks are uncommon but real, and your surgeon will go through them with you before you consent.

Alternatives worth discussing first

Hysterectomy is a permanent step, so it is worth being sure the alternatives have been considered:

  • Medical treatment — tablets to reduce heavy bleeding or pain
  • The hormonal coil (LNG-IUS) — often very effective for heavy periods
  • Endometrial ablation — treating the womb lining rather than removing the womb
  • Myomectomy — removing fibroids while keeping the womb, if fibroids are the problem

See our guide to heavy, irregular and painful periods for more on these options.

How you might feel about it

Deciding to have your womb removed can carry real emotional weight, even when the medical case is clear. Some women feel relief, others feel a sense of loss, and both are normal. Talk to us about it, and consider talking to someone you trust or a counsellor if it would help.

The bottom line

TLH is a safe, well-established way of removing the womb with less pain and a faster recovery than open surgery, and most women go home after one night. It suits many women, but it is not the only option — make sure you have discussed the alternatives. If you are considering it, see a gynaecologist with specific training in laparoscopic surgery.

References

  1. National Health Service. Hysterectomy [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/hysterectomy/
  2. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. NG88. London: NICE; 2018. Available from: https://www.nice.org.uk/guidance/ng88
  3. Royal College of Obstetricians and Gynaecologists. Patient information leaflets [Internet]. London: RCOG; [cited 2026 Jul 22]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/