Hysterectomy (Both Laparoscopic + Open)

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  2. Hysterectomy (Both Laparoscopic & Open)

What is Hysterectomy?

Hysterectomy is a surgical procedure that entails the removal of the uterus.

A woman-specific surgery, the hysterectomy procedure is also performed to remove the fallopian tubes and ovaries, depending upon the medical condition diagnosed.

Post-uterus removal, a woman will not be able to achieve pregnancy nor will she menstruate any further.

A hysterectomy is recommended for a variety of reasons including chronic pain, infections, and cancer. The extent of the surgery depends on the condition and its severity.

Who should have Laparoscopic Hysterectomy surgery?

Most patients who are having a hysterectomy to treat abnormal uterine bleeding or fibroids can have a laparoscopic hysterectomy. It may not be possible in some cases. For example, if the uterus is bigger than a 4 month pregnancy, if she’s had multiple previous operations in her lower abdomen. It is usually not done for women with a gynecologic cancer.

The Recovery Period

Complete recovery following a hysterectomy can take anywhere from 2 to 6 weeks based on the type of procedure. It's important to start walking as soon as possible after your surgery to reduce the risk of dangerous blood clots. You'll need to refrain from heavy lifting, strenuous activity, and sexual intercourse for a while following the procedure. Your surgeon will let you know when it's safe to resume these activities.

You should contact your doctor if you experience
  • Redness or discharge at the incision site
  • Unusual vaginal discharge or persistent heavy bleeding
  • Difficulty having a bowel movement or urinating
  • Chest pain or shortness of breath
  • Severe pain
  • Fever or chills
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What is Appendix?

The appendix is a narrow, small, finger-shaped portion of the large intestine that is generally situated near junction of small and large intestine (Cecum) on lower right side of the abdomen.

Appendicitis

Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can burst, causing infection and could be even fatal.

Six GYN Conditions that may warrant Hysterectomy

A hysterectomy is a major surgical procedure. It is performed in the hospital Operating Suite with an Anesthesiologist providing general anesthesia and one, sometimes two, of our OB-GYNs operating together, to perform the surgery. By removing the uterus, the procedure addresses many uterine conditions that often result in a restoration of your health, allowing you more freedom, and occasionally even saving your life in situations where cancer, profound anemia or infection is a present. Here are six of the most common conditions that may warrant hysterectomy:

  • Endometriosis- a condition that can only truly be diagnosed by visualization of the pelvis. Ultrasound and clinical exams can be suggestive but are not diagnostic.Endometrial cells adhere to surfaces within the pelvis and grow to cause pain, scarring and bleeding. If the endometriosis invades into the walls of the uterus, it’s called adenomyosis and can only be diagnosed and often treated by uterine removal, or hysterectomy.
  • Abnormal uterine bleeding (AUB) - heavy periods or protracted irregular bleeding which can result in anemia, transfusions, extreme fatigue, shortness of breath and potential cardiac compromise.
  • Pelvic support problems - (uterine and vaginal wall prolapse), which cause symptoms such as stress urinary incontinence and pelvic pain, painful intercourse or present with a noticeable bulge at the opening to the vagina (introitus). This condition is more common in post-menopausal women and in women who have had multiple vaginal births.
  • Chronic pelvic pain- sometimes caused by endometriosis, adhesions or past pelvic inflammatory disease (PID)
  • Uterine fibroids - benign smooth muscle tumors involving the uterine myometrium. The condition is common; about 1in 3 women will have at least one fibroid.They can be small and innocuous or large, elicit heavy menstrual bleeding and compression of other pelvic structures, like your bladder and intestines. Sometimes small fibroids are problematic if they protrude into the uterine cavity as they tend to be vascular and bring about heavy bleeding.
  • Cancer - endometrial and ovarian cancers are managed with hysterectomy and may also warrant lymph node sampling and directed biopsies. Hysterectomies for cancer are typically performed by a GYN Oncologist.

Hysterectomy Treatment

A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. A small incision is made in the belly button and a tiny camera is inserted. The surgeon watches the image from this camera on a TV screen and performs the operative procedure. Two or three other tiny incisions are made in the lower abdomen. Specialized instruments are inserted and used for the removal process.

Some women do not have their ovaries removed when they undergo a hysterectomy. If the ovaries stay inside, the woman does not need to take any hormones after the surgery and she does not have hot flashes. Some women remove their ovaries because of family history of ovarian cancer or they have an abnormal growth on their ovary.

Women can choose to either keep the cervix in place (called a “laparoscopic supra-cervical hysterectomy”) or remove the entire uterus and cervix (“ total laparoscopic hysterectomy”).

Keeping the cervix in place makes the operation a little faster and safer. When the cervix is in place there is a 5% chance that the woman will have monthly spotting at the time of her menstrual periods. Women whose cervices stay in place need to continue getting pap smears.

If the woman wants to be 100% certain that she will never menstruate again, she needs to have the entire uterus removed. If the patient has a history of pre-cancerous changes of the cervix or uterine lining, she should have the entire uterus removed. If the operation is being done for endometriosis or pelvic pain, many doctors think the chances for pain reduction are better if the cervix is removed.