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Hysterectomy is a surgical procedure to remove a woman’s uterus. It is a very common treatment for women with severe uterine health problems. Most of the time this is done as a “traditional open surgery” with a hospital admission with a three or four day hospital recovery and a large incision.
There are very few surgeons that perform this surgery laparoscopically on an outpatient basis. I do 99% of mine this way.
Following hysterectomy surgery, a woman is no longer able to become pregnant.
Many women choose a hysterectomy after they have exhausted all other treatment options, or will wait to have a hysterectomy until they are finished having children, which is not an uncommon practice.
Some women with a family history of some cancers, they may chose this procedure to help reduce the chances of such problems as they age.
Some conditions that may be treated with a hysterectomy include:
Severe endometriosis
Uterine fibroids
Prolapsed uterus
Cancer of the uterus or other nearby reproductive organs
Abnormal uterine bleeding
Chronic pain
Elective hysterectomy surgery
Some women may choose to have elective surgery to remove their uterus, ovaries, and/or fallopian tubes if they are at high risk for cancer. If you have a strong family history of cancer, or you are a member of another high-risk group, talk with your gynecologist about elective risk-reduction surgery.
What is Removed During a hysterectomy surgery?
There are three primary types of hysterectomy, categorized by the amount of tissue that is removed.
Total abdominal hysterectomy
This is the removal of the uterus and the cervix through an incision in the abdomen.
Supracervical hysterectomy
Also called a partial hysterectomy, this is the removal of the uterus only. The cervix is left intact. A supracervical hysterectomy may be performed through abdominal surgery or laparoscopic surgery.
Radical hysterectomy
In this procedure, the uterus and cervix are removed, as well as some surrounding tissue, such as the ovaries (oophorectomy) or fallopian tubes (salpingectomy). Your doctor may recommend this procedure if you have gynecologic cancer, or if your pelvic organs are affected by endometriosis.
What Methods are used to perform a Hysterectomy?
There are a few common methods used to perform a hysterectomy. The method your doctor will recommend will depend on upon your medical history, your age, your general health, and how much tissue is to be removed. It’s possible that the surgeon may begin the hysterectomy with one method, but then change methods if they find other existing complications.
Abdominal hysterectomy
This is the most common type of hysterectomy surgery. This is an “open surgery” that requires hospital admission and several days of in patient recovery.
The surgeon makes an incision in your lower abdomen, underneath your navel, to expose the pelvic organs. The tissue is then removed through the incision. Abdominal surgery is traditionally recommended for women with large uteruses or have pelvic scar tissue from damage or disease, such as adhesions. This type of surgery carries some risk of complications, including bleeding, tissue damage, and infections.
Laparoscopic hysterectomy
As I said earlier, virtually all of my hysterectomies are performed laparoscopically on an outpatient basis. Here I makes a few tiny incisions in the patient’s abdomen and completes the surgery with the aid of a laparoscope – a narrow, flexible instrument with a lighted camera at the end.
Traditionally, the tissue is removed in small pieces through the incisions, but this is not how we perform this surgery. This is because with this method there is a risk of spreading cells throughout the abdomen. This is not what we want in case there are any pre-cancerous cells in the tissue. It’s just not safe.
So what we do is wrap the
This type of surgery is usually less painful than an abdominal hysterectomy and carries less risk of infection. Also, the recovery time is much quicker than an abdominal surgery, which means less time in the hospital.
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Laparoscopic-assisted vaginal hysterectomy (LAVH)
This procedure removes the uterus through the vagina, with the assistance of a laparoscope inserted through small incisions in your abdomen. There are generally fewer risks with this type of surgery, and recovery time is much quicker than with abdominal methods. However, women who have very large uteruses or who have pelvic adhesions, may not be able to have this type of surgery.
Robotic-assisted hysterectomy
This procedure is typically conducted laparoscopically with the aid of a robotic surgical instrument that the surgeon controls.
Hysterectomy Recovery
Depending on the type of surgery, you will need to stay in the hospital for a few days following the procedure. You will likely experience some pain, however, your doctor can help you manage this with medication.
As with most major surgeries, blood clotting is one possible complication. You will be asked to walk around after your surgery to facilitate circulation in your legs.
It’s normal to experience some mild to moderate vaginal bleeding and discharge following the surgery. Use sanitary pads instead of tampons. It might be difficult to have a bowel movement or completely empty your bladder for a few days after a hysterectomy.
For 6-8 weeks after your surgery, you should:
- Get plenty of rest
- Avoid heavy lifting
- Get some light exercise. Taking short walks every day will improve your circulation and help you regain your strength.
- Avoid vaginal intercourse
- Avoid inserting anything into your vagina, including douches and tampons
- Call your gynecologist if you experience any signs of infection, such as fever, chills, nausea, or vomiting
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