Dr. Preeti Tandon
(Specialist Obstetrics & Gynaecology Laparoscopic & Robotic Surgeon. )

MBBS, MD(Obs/Gynae), F.MAS(Laparoscopic Surgeon), FICOG
Diploma in Adv Gynae Endoscopy (France), Certified Robotic Surgery Training (USA).

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Laparoscopic Hysterectomy

A hysterectomy is kind of surgical procedure which involves the removal of the womb (uterus).It is considered as the second most performed surgery for women who is in the reproductive age. But it is recommended or shouldn’t be performed on women who still want to have children unless no other alternatives are left for the treatment.

Reasons for a hysterectomy?

Hysterectomies are usually carried out in the conditions that directly affect the female reproductive system:

  • Chronic pelvic pain
  • Uncontrollable vaginal bleeding
  • Fibroids
  • Pelvic inflammatory disease ( developed from the infection of the reproductive organs)
  • Uterine prolapse (uterus comes down through the cervix and protrudes from the vagina)
  • Endometriosis (disorder happens in which the inner lining of the uterus grows outside uterine cavity)
  • Adenomyosis (causes excessive pain and bleeding)
  • Gynecologic cancer of the uterus, cervix, ovaries or of the fallopian tubes

A hysterectomy is a major operation and it is only tried after some alternative which are less invasive, treatments have been tried.

Things to consider

If you have a hysterectomy, you have to decide whether to also have the cervix or ovaries removed. The decision is generally rely on one`s personal feelings, medical history and any recommendations doctors may have.

Types of hysterectomy

There are various types of hysterectomy. The type you have depends on why you need the operation and how much of your womb and surrounding reproductive system can safely be left in place.

The main types of hysterectomy are:

  • Total hysterectomy – the womb and cervix are removed; this is considered as the most usual performed operation
  • Subtotal or Supracervical hysterectomy – the main body of the womb is removed, leaving the cervix in place
  • Total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes and the ovaries are removed.
  • Radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, ovaries, part of the vagina, lymph glands and fatty tissue.

Different ways to perform a hysterectomy:

  • Vaginal hysterectomy – the womb is removed by making a cut in the vagina
  • Abdominal hysterectomy – the womb is removed through a cut in the lower abdomen area
  • Minimal Invasive hysterectomy (keyhole surgery) laparoscopic or robotic – – the womb is removed through making several small cuts in the abdomen

Keyhole surgery requires only require some tiny incisions in the abdomen. A laparoscope inserted through one of these tiny incisions allows the surgeon to keenly examine the pelvic organs. Other surgical instruments are used to perform the surgery through small 5 mm incisions.

Benefits of keyhole hysterectomy?

Compared with the abdominal hysterectomy, laparoscopic /robotic surgery resulted in much less pain, comes with a lower risk of infection, and requires a shorter hospital stay.

Complications of a hysterectomy

There's a small risk of complications, including:

  •  heavy bleeding
  • infection
  • damage to your bladder or bowel
  • Anaestheisa risks

Alternatives to hysterectomy?

In some cases, medications or other procedures that allow you to become pregnant now or in the near future can be tried before having a hysterectomy. Some women wait to have a hysterectomy until after they have completed their families. If you choose another option besides hysterectomy, keep in mind that you may need additional treatment later.

Recovery after Hysterectomy.

You stay in the hospital will extend to the maximum of few days after surgery. Your stay in the medical facility will entirely depend on the type of hysterectomy and how it was performed. If it is a keyhole surgery then you will be discharged within the course of 24 hours. You can feel some pain for the first few days after the surgery. So your doctor will recommend you some medication to relieve pain. You may have discharge from your vagina for several weeks due to the procedure.

Some important things about recovery

Follow all the keen instructions of your health care provider. Always take plenty of rest after the treatment, but you also have to move around yourself through some exercise and do these as much your body bears it. Do not insert anything in your vagina during the course of first 6 weeks. These activities include douching, having sex, and using tampons.

After you fully recovered, you must continue to visit your specialist for the routine gynecologic exams and general health examination. Depending on the particular reason for your hysterectomy, you still need some pelvic exams and cervical cancer screening.