A hysterectomy is a surgical operation to removal all or part of the uterus. There are different types of hysterectomy procedures, including:
- Vaginal Hysterectomy
This procedure is most often used in cases of uterine prolapse, or when vaginal repairs are necessary for related conditions. During a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes, and upper vagina, as well as from the blood vessels and connective tissue that support it. The uterus is then removed through the vaginal opening. If a patient’s uterus is enlarged, a vaginal hysterectomy may not be possible.
- Laparoscope-assisted Vaginal Hysterectomy (LAVH)
LAVH uses a laparoscope (a thin, flexible tube containing a video camera) to guide the removal of the uterus and/or fallopian tubes and ovaries through the vagina. During LAVH, several small incisions are made in the abdominal wall through which slender metal tubes known as “trocars” are inserted to provide passage for a laparoscope and other microsurgical tools. Next, the uterus is detached from other structures in the pelvis using the laparoscopic tools. The fallopian tubes and ovaries are also detached from their ligaments and blood supply. The organs and tissue are then removed through an incision made in the vagina. LAVH typically requires a one to three day hospital stay. Complete recovery time is usually four weeks.
- Robotic-assisted Laparoscopic Hysterectomy
During a robotic-assisted laparoscopic hysterectomy, a surgeon controls the movements of robotic arms from a computer station in the operating room. Three or four small incisions are made near the belly button. Gas may be pumped into the belly to distend it and give the surgeon a better view and more room to work. The laparoscope is inserted the abdomen, while other surgical instruments are inserted through the other incisions. The uterus will be cut into small pieces that can be removed through the small incisions. Depending on the reasons for a patient’s hysterectomy, the entire uterus may be removed or just the part above the cervix. The fallopian tubes and ovaries attached to the uterus may also be removed. Most people stay in the hospital for a few days. Complete recovery may take anywhere from a few weeks to a few months.
- Abdominal Hysterectomy
The uterus is removed through the abdomen via a surgical incision about six to eight inches long. The incision can be made either vertically, from the navel down to the pubic bone, or horizontally, along the top of the pubic hairline. The tissues connecting the uterus to blood vessels and other structures in the pelvis are then carefully cut away. The uterus is removed, along with any other structures such as the ovaries, fallopian tubes, and cervix, depending on each patient’s situation. Abdominal hysterectomy usually requires a hospital stay of one to two days, but it could be longer. The recovery period is usually about six to eight weeks.