Hysterectomy 101

You have heard the term hysterectomy many times before but do you really know what it is, why women have this surgery, and what are the different routes of procedure you can take?  

A total hysterectomy is the surgical removal of the uterus, and when indicated, the additional removal of the fallopian tubes and ovaries (termed salpingoophorectomy) may be recommended. Although it is a more private surgery, it is the most performed gynecological surgery on women in the United States. Hysterectomies are performed for those with uterine and reproductive conditions. Some include reproductive cancers, uterine fibroids, endometriosis, and postpartum.

If a time comes when you and your gynecologist think about the possibility of a hysterectomy, it is important to know what the surgery entails and the safest routes for your particular body. Dr. Suzanne Hall of Gyno Groupie, shared her knowledge and advice on this topic.

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There are several routes by which a hysterectomy can be performed. You and your gynecologist will decide on the safest route for your hysterectomy based off the clinical circumstances for the hysterectomy, your particular health history, and the surgeon's clinical expertise. 

The 4 main routes by which a hysterectomy is performed are listed here:

1. Abdominal Hysterectomy: In an abdominal hysterectomy, an abdominal skin incision (similar to a cesarean section incision) is made to accomplish the surgery. This route is especially advantageous when large uterine fibroids or significant abdominal adhesions are anticipated, allowing for more exposure to accomplish the surgery safely. Compared with the other minimally invasive routes, abdominal hysterectomy generally requires a longer hospital stay and longer recovery time.

2. Laparoscopic Hysterectomy: Laparoscopic hysterectomy involves the use of a narrow camera (termed a laparoscope) and surgical instruments. They're placed through small abdominal skin incisions to detach the uterus, which is then most commonly delivered through the vagina. This route may be selected when abdominal adhesions or a moderate-to-large sized uterus are suspected. The advantage with this minimally invasive approach is a shorter hospital stay and faster recovery time, when compared with abdominal hysterectomy.

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3. Davinci Assisted Laparoscopic Hysterectomy: Your surgeon may offer a Davinci hysterectomy. This surgery is an advanced form of the laparoscopic surgery, with proposed improved precision, visualization, and technical capabilities. This is beneficial for more complex procedures.

4. Vaginal Hysterectomy: In the vaginal route (termed vaginal hysterectomy), the uterus is completely removed through the vagina, thereby avoiding any abdominal incisions. This route may be selected for a normal-to- moderately enlarged uterus, for pelvic organ prolapse, or when significant abdominal adhesions are not suspected. As with laparoscopic and Davinci hysterectomy, a shorter hospital stay and faster recovery are expected. 

Though hysterectomies are the most common gynecologic surgery performed among women in the United States, any surgical procedure has inherent risks. A hysterectomy may be the best choice for your gynecologic condition. Be sure to consult with your physician in understanding the risks versus benefits. It is valuable to be aware and knowledgeable about the options for this surgery, for yourself or other women in your lives. 

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