Surgical Methods

There are several different forms of hysterectomy. These include:

-Supracervical hysterectomy: Removes some or all of the uterus, but keeps the cervix in place.
-Total hysterectomy: Removes all of the uterus and cervix.
-Radical hysterectomy: Removes the whole uterus, the tissue on either side, the cervix and the top of the vagina. It is generally only performed in cases of cancer.
-A surgeon may also perform an oophorectomy, the removal of the ovaries. Whether this is necessary will depend on several factors to do with the patient and their condition. In cases when both ovaries, both fallopian tubes and the entire uterus are removed, the procedure is called a Hysterectomy & Bilateral Salpingectomy.

Issues such as healing time and scarring will depend on which method has been performed. In some cases, a surgeon can use the minimally invasive laparoscopic method. In others, traditional ‘open’ surgery will be necessary.

Open Hysterectomy

Abdominal, open hysterectomy is the most common form of the procedure. It requires a five to seven-inch incision, made either vertically or horizontally in the abdomen. It usually requires an inpatient stay of several days in the hospital. There will be a visible scar at the point of the incision.

Minimally-Invasive Hysterectomy

There are several possible methods for minimally invasive hysterectomy. Your doctor will assess whether you are a candidate for any of these options.

-Vaginal hysterectomy: An incision is made in the vagina and the uterus is removed through it. The incision leaves no visible scar after it has been closed.
-Laparoscopic hysterectomy: Multiple small incisions are made in the abdomen and the surgeon operates from outside the body, using a screen to view the surgical area.
-Robot-assisted laparoscopic hysterectomy: A surgeon performs the procedure from outside the body with the assistance of robotic equipment.

If a patient is a suitable candidate for it, minimally invasive hysterectomy offers several advantages. It allows for a faster recovery and a shorter hospital stay. There is generally less post-operative pain and scarring and a lower chance of infection at the surgical site than with abdominal hysterectomy. It is usually possible to resume ordinary activity within three to four weeks of a laparoscopic hysterectomy, as opposed to four to six weeks for an open procedure.

Certain factors can make an individual unsuitable for minimally invasive hysterectomy. These may include the patient’s weight, the size and condition of the uterus, any scar tissue in the surgical area, and overall health. Your doctor will assess all relevant factors and provide information and options.

Risks

Hysterectomy is a safe and reliable procedure with a very high success rate. It does carry certain risks, but these are extremely rare. It carries the standard risks of surgery, such as infection, blood clotting, and injury to surrounding organs, but these occur very rarely. There is also a risk of urinary incontinence and vaginal prolapse, but again these are extremely rare.

After the Procedure

As noted above, open hysterectomy and laparoscopic hysterectomy generally require different lengths of hospital stay and recovery time. Your doctor will advise you on the details. You should abstain from activities such as sex, lifting heavy objects and strenuous exercise for six weeks after a hysterectomy. Your medical team will monitor your recovery. You should let them know immediately if you are experiencing intense or persistent pain or any signs of possible infection.

After a hysterectomy which also involves the removal of the ovaries, you will be in menopause. If the ovaries were not removed, you will likely begin menopause at an earlier age than you would have otherwise.