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Click here to download the patient brochure for Hysterectomy utilizing minimally invasive da Vinci Robotic Surgery

Hysterectomy Options

Hysterectomy Facts

  • One out of every three women will have a hysterectomy
  • Approximately 60 percent of those women will experience a prolonged recovery due to traditional open surgical methods
  • Hysterectomy is the second most common major surgery among women in the United States
  • Hysterectomy is the surgical removal of the uterus
  • Surgical removal of the ovaries (oophorectomy) is often performed at the same time
  • Hysterectomy can be a treatment option for women experiencing
    • Fibroids
    • Endometriosis
    • Prolapse
    • Uterine cancer
    • Abnormal uterine bleeding

Anatomy of the Uterus

Types of Hysterectomies

  • Open or “traditional” procedures
  • Minimally invasive procedures (MIP)

Total Abdominal Hysterectomy (TAH)

Also known as “traditional” or “open” procedure

  • Large incision or “bikini cut” (4–6 inches) in the abdomen to gain access to the inside of the body and provide an open view of internal organs
  • Tissues of the abdominal wall are stretched apart and uterus is removed

Total Abdominal Hysterectomy (TAH)

  • Requires three to five day hospital stay
  • Normal activity can usually resume in six weeks

Minimally Invasive Procedures

Two types of minimally invasive procedures (MIP) for hysterectomy

  • Vaginal hysterectomy
  • Laparoscopic procedures
    • Laparoscopically assisted vaginal hysterectomy (LAVH)
    • Laparoscopic superacervical hysterectomy (LSH)

Vaginal Hysterectomy

  • Incision (approximately 1 inch) made at the top of the vagina
  • Uterus and cervix are separated from the body and removed through the vagina
  • Abdominal walls are not stretched
  • Requires one to three day hospital stay
  • Normal activity can usually resume in four weeks

Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

  • Incision (approximately 1 inch) made at the top of the vagina
  • Uterus and cervix are removed through the incision
  • Prior to removal, a laparoscope (miniature camera) is inserted through a small abdominal incision to view the uterus and surrounding organs
  • Uterus is detached under view of the laparoscope using special laparoscopic surgical tools inserted through small incisions
  • Requires one to three day hospital stay
  • Normal activity can usually resume in four weeks

Laparoscopic Supracervical Hysterectomy (LSH)

  • Uterus is removed using only laparoscopic tools
  • Using instruments, the surgeon separates the uterus from the cervix and removes it through one of the abdominal incisions
  • Requires one to three day hospital stay
  • Normal activity can usually resume in four weeks
The LSH procedure uses a thin, lighted telescope-like instrument called a laparoscope, which acts like a video camera, along with small surgical instruments that are all inserted through three to four tiny incisions (less than ¼ inch each) in the navel and abdomen. Using the instruments, the surgeon carefully separates the uterus from the cervix and removes it through one of the openings. The cervix, the bottom part of the uterus, is left intact. Because this type of surgery does not require the surgeon to make a large abdominal incision, you will not have the same kind of visible scar typical with most traditional, “open” surgeries.

Some research suggests that preserving the cervix may help to reduce the risk of pelvic floor prolapse, urinary incontinence and other complications associated with total hysterectomies. However, with the cervix in place, it means that following an LSH, you must be willing to continue getting annual Pap smears to screen for cervical cancer. In addition, this procedure may not be appropriate if you have large or numerous fibroids. Download Brochure

Laparoscopic Supracervical Hysterectomy (LSH), OBGYN Ohio

Why Consider a Minimally Invasive Procedure

  • Most MIP patients have*
  • Quicker recovery
  • Less time in the hospital
  • Less post-operative pain
  • Less scarring

Risks and Complications

Both types of hysterectomy — traditional and MIP have risks including:

  • Reactions to medications or problems resulting from anesthesia
  • Breathing problems
  • Bleeding
  • Infection
  • Blood clots in the veins or lungs
  • Death (rare)
  • Inadvertent injury to the organs and vessels near the uterus

Risks Specific to Traditional Hysterectomy

  • Muscle injury
  • Post-operative incisional hernia

Discuss the Options With Your Physician

  • Understand the reasons why you may need your uterus removed
  • Find time to discuss the surgery away from the examining room when you are fully dressed and comfortable
  • Bring questions and take notes
  • Consider including a friend or family member in the discussion

Questions to Ask Before Your Hysterectomy Procedure

  • How long will it take me to recover?
  • When will I be able to leave the hospital?
  • Will my ovaries or any reproductive organs other than my uterus be removed?
  • When can I resume normal activities, including school, work, exercise, sexual activity, and recreation?
  • What type of hysterectomy will I have?
  • Is any type of minimally invasive procedure appropriate for my situation?
  • Which organs will be removed?
  • Exactly where, and how big will the incisions be?
  • Is this the least invasive procedure available for my condition?
  • How many of these procedures have you performed in the past 12 months?

Choosing MIP over Traditional Surgery

Your surgeon will help you determine if MIP is an appropriate choice for you

Factors to consider include:

  • Obesity
  • History of abdominal surgery causing dense scar tissue
  • Inability to safely visualize organs
  • Bleeding problems during the operation
  • Underlying medical conditions

Advantages of Minimally Invasive Procedures (MIP)

  • Quicker recovery
  • Less time in the hospital
  • Less post-operative pain
  • Less scarring

References

  • National Women’s Health Information Center. “Hysterectomy.” [Online] November 2002 http://www.4woman.gov/faq/hysterectomy.htm
  • Hysterectomy Solutions. “Feel Like Yourself Sooner.” [Online] http://www.hysterectomyoptions.com/dtcf/

 

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