Total Laparoscopic Hysterectomy by Dr. R.K. Mishra. TLH is a minimal access surgical procedure which facilitates the removal of non prolapsed uterus through the vaginal route. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside the patient's abdomen. The main benefit of this sort of hysterectomy is that patient will not need to possess a large cut in your abdomen as well as your recovery is generally much faster.