Hysterectomy

The types of hysterectomy, depending on which structures or organs are removed.

As a general rule, before any type of hysterectomy, women should have the following tests in order to select the optimal procedure:

• Complete pelvic exam including manually examining the ovaries and uterus.
• Up-to-date Pap smear.
• Pelvic ultrasound may be appropriate, depending on what the physician finds on examination.
• A decision regarding whether or not to remove the ovaries at the time of hysterectomy.
• A complete blood count and an attempt to correct anemia if possible.

Types of hysterectomy :

1. Total abdominal hysterectomy
2. Vaginal hysterectomy
3. Laparoscopy-assisted vaginal hysterectomy
4. Supracervical hysterectomy
5. Laparoscopic supracervical hysterectomy
6. Radical hysterectomy

1) Total abdominal hysterectomy, the most common type

The total abdominal hysterectomy is the most common type of hysterectomy. During a total abdominal hysterectomy, the doctor removes the uterus, including the cervix. The scar on the abdomen may be horizontal or vertical, depending on the reason the procedure is performed, and the size of the area being treated.

Scar from incision

Abdominal Hysterectomy

2) Vaginal hysterectomy procedure :

During this procedure, the uterus is removed through the vagina. A vaginal hysterectomy is appropriate for conditions such as uterine prolapse, endometrial hyperplasia, or cervical dysplasia.

3) Laparoscopy-assisted vaginal hysterectomy/ Total Laparoscopic Hysterectomy

Laparoscopy-assisted vaginal hysterectomy (LAVH) is similar to the vaginal hysterectomy procedure described above, but it adds the use of a laparoscope. A laparoscope is a very thin viewing tube used to visualize structures within the abdomen.

3) Laparoscopy-assisted vaginal hysterectomy/ Total Laparoscopic Hysterectomy

Laparoscopy-assisted vaginal hysterectomy (LAVH) is similar to the vaginal hysterectomy procedure described above, but it adds the use of a laparoscope. A laparoscope is a very thin viewing tube used to visualize structures within the abdomen.

In Total Laparoscopic

Hysterectomy ,entire surgery is done through abdominal tiny ports

Procedure

The procedure is done under general anaesthesia in the operating room. A small incision is made just below your umbilicus. The abdomen is inflated with gas and a fibre-optic instrument called laparoscope is inserted to view the internal organs. Further small incisions may be made on your abdomen through which tiny surgical instruments are passed. Then uterus and cervix are removed along with or without both ovaries and tubes.

4) Supracervical hysterectomy

A supracervical hysterectomy is used to remove the uterus while sparing the cervix, leaving it as a "stump."

5) Laparoscopic supracervical hysterectomy

The laparoscopic supra cervical hysterectomy procedure is performed like the LAVH procedure, but the uterus is separated from the cervix, and the uterine tissue is removed through the laparoscopic incision. Recovery is generally faster than with other types of hysterectomy.

6) Radical hysterectomy

The radical hysterectomy procedure involves more extensive surgery than a total abdominal hysterectomy because it also includes removing tissues surrounding the uterus and removal of the upper vagina. Radical hysterectomy is most commonly performed for early cervical cancer.

Complications of a hysterectomy include:

• Infection
• Pain
• Bleeding in the surgical area.

An abdominal hysterectomy has a higher rate of post-operative infection and pain than does a vaginal hysterectomy.

What are the alternatives to a hysterectomy?

A hysterectomy for conditions other than cancer generally are not considered until after other less invasive treatments are unsuccessful.