Gynecology - Conventional gynecologic surgery

 

Abdominal Hysterectomy

Hysterectomy — removal of the uterus — is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other treatments first. For conditions that have not responded to other treatments, a hysterectomy may be the best choice. It depends on the effect of the condition and the surgery on your life.

 

The uterus is a muscular organ in the pelvis. The opening of the uterus is the cervix. During pregnancy, the uterus holds and nourishes the fetus. In labor, it contracts to help deliver the baby. When a woman is not pregnant, the lining of the uterus (the endometrium) is shed each month in her menstrual period.

 

Hysterectomy is the surgical removal of part or all of the uterus. It is the second most common major surgery among women of child-bearing age. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include:

• Uterine fibroids
• Endometriosis
• Pelvic support problems (such as uterine prolapse)
• Abnormal uterine bleeding
• Cancer
• Chronic pelvic pain
  

 

A hysterectomy can be:

• Subtotal (also called partial or supracervical), in which the upper part of the uterus is removed but the cervix is left in place
• Total, in which the entire uterus, including the cervix, is removed
• Radical, in which the entire uterus and support structures around the uterus are removed (this is done if certain types of cancer are present)
  

 

A hysterectomy does not include removal of the ovaries and fallopian tubes. When these organs are removed at the same time as the uterus and cervix, it is called a salpingo-oophorectomy. In abdominal hysterectomy, the doctor makes an incision (cut) through the skin and tissue in the lower abdomen to reach the uterus. The incision may be vertical or horizontal. Abdominal hysterectomy requires a longer healing time than vaginal or laparoscopic surgery. But there can be advantages to having an abdominal hysterectomy. This type of hysterectomy gives the surgeon a good view of the uterus and other organs during the operation. The doctor may suggest this procedure if you have large tumors or if cancer may be present.

Unfortunately, abdominal hysterectomy generally requires 2 to 4 days of recovery in the hospital plus up to 6 weeks of recovery at home. Nonetheless, almost 70% of all hysterectomies are performed abdominally. Today, minimally invasive surgical approaches to hysterectomy provide significantly reduced postoperative pain and time to full recovery.

 

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