A hysterectomy is a surgery for removing a female’s uterus. A woman may undergo the surgery for several different reasons, such as:
- Thickening of the uterus or Adenomyosis
- Cervical, Uterine or Ovarian cancer
- Uterine Fibroids causing bleeding, pain and several other issues.
- Prolapsed Uterus – it is descending of the uterus into the vaginal canal from its original position
- Chronic Pelvic Pain
- Unusual vaginal bleeding
This kind of surgery for non-cancerous issues is generally considered only after all other remedial approaches have been attempted but resulted in failure.
Types of the Surgery
Based on the reason, your doctor may prefer to remove the entire or just a branch of the uterus. The healthcare providers and patients sometimes use these nuances inappropriately. So, it is of utmost importance for you to clarify if the ovaries and/or cervix are also to be removed.
- In a subtotal or supracervical hysterectomy, the doctor eliminates only the upper portion of the uterus and keeps the cervix intact.
- In a total hysterectomy, the entire uterus along with its cervix is removed.
- In a major surgical operation, known as a radical hysterectomy, a surgeon removes the whole of the uterus, the tissues on the sides of the uterus, the cervix, and the upper portion of the vagina. This is usually performed only in the cases of uterine cancer.
The doctors perform hysterectomy with different approaches. They determine their approach depending on the reason for opting hysterectomy and the involved female’s overall health condition, besides the experience of the operating surgeon.
The hysterectomy approach partly decides the healing period and the type of scars that remain after the surgery.
There are mainly two types of hysterectomy operation:
- Traditional or open surgery
- Surgery using a minimally invasive procedure (MIP)
Open Hysterectomy Surgery
This surgery performed from the abdomen is called an open surgery. This is the usual method of performing a hysterectomy. Almost 65% of the these surgical procedures are performed in this manner.
For performing an open/abdominal surgery for removing the uterus, the surgeon will make an either side-to-side or up-and-down incision of between 5 and 7 inches diagonally in the belly. Through the incision, the surgeon skillfully removes the uterus.
On an average, a woman undergoing abdominal surgery expends nearly three to four days in the Clinic. Besides, a scar at the site of the incision takes its own healing time.
Minimally Invasive Procedure (MIP) Hysterectomy
There are several methods that are used for performing a minimally invasive hysterectomy procedure:
- Vaginal hysterectomy: The operating surgeon makes an incision in the vagina for removing the womb through this cut. The cut is afterwards carefully closed so that the scar at the incision site is not visible.
- Laparoscopic hysterectomy: The laparoscopy operation is performed by using a laparoscope. The laparoscope is a tube fitted with a lighted camera. The surgical instruments are inserted via many small incisions made in the stomach. In case of just a single location laparoscopic procedure, a small incision is made around the belly button.
The operating surgeon executes the hysterectomy externally by viewing the surgery on a computer screen.
- Vaginal hysterectomy assisted by Laparoscopy: The surgery is performed with laparoscopic surgical instruments. The operating surgeon eliminates the uterus by making a cut in the vagina.
- Laparoscopic hysterectomy assisted by Robot: This method is quite similar to the hysterectomy performed with laparoscopy. The operating surgeon commands a classy programmed system of surgical instruments externally. This kind of advanced equipment helps the surgeon in performing hysterectomy just by using his normal wrist movements. The surgeon can watch the hysterectomy procedure happening on a 3D screen.
Comparative evaluation of Hysterectomies – MIP and Abdominal
Compared to the conventional open surgery for performing an abdominal hysterectomy, MIP method is considered much beneficial. The main advantages are:
- Speedy recovery
- Shorter stay in the Clinic/Hospital
- Lesser pain
- Lesser scarring
- Minimal chances of infection
After going through hysterectomy with the MIP, women may resume their routine activities within 3 to 4 weeks, whereas with an open surgery, it takes them to resume routine activities on an average 4 to 6 weeks.
Besides, the costs linked with a minimally invasive procedure (MIP) of hysterectomy are significantly on the lower side as compared to the abdominal surgery. But this all depends on the utilization of tools and the time taken while performing surgery. However, robotic methods of hysterectomy are expensive.
Hysterectomy performed with the MIP holds the lesser amount of risk of getting incisional hernia.
Not all females are suited to the minimally invasive procedure of a hysterectomy. The existence of scar tissues of previous surgeries, health condition and obesity may affect the suitability to an MIP hysterectomy. You are advised to discuss whether an MIP hysterectomy will be suitable for you or not.
There are very low risks of undergoing the surgery. Mostly females, who undergo this surgery, face no serious complications and problems. However, as it happens with any kind of surgery, hysterectomy may also bring certain complications in a very few females. These probable complications are:
- Vaginal prolapsed (a part of vagina falls out of the body)
- Incontinence (withholding) of urine
- Chronic pain
- Formation of Fistula (an irregular link that appears between the bladder and vagina)
Some other uncommon risks arising out of hysterectomy are:
What you should expect after undergoing Hysterectomy
After undergoing hysterectomy, if your ovaries have also been removed, you will attain menopause. If your ovaries have not been removed, you may attain menopause earlier than you ought to have otherwise.
Mostly females are advised to refrain from indulging in copulation and avoiding lifting of heavy objects for nearly 6 weeks after undergoing hysterectomy.