Hysterectomy (removal of the uterus) is the procedure where uterus is being removed, it is the second most frequently performed surgery on women following caesarean section. It is the last options offered to women above the age of 45 years and who have completed their family
Indications of hysterectomy
– Leiomyomas (Fibroids) which are causing severe symptoms and who has completed family.
– Abnormal uterine bleeding not responding to medical management.
– Endometriosis: in the presence of severe symptoms with failure of other options.
– Pelvic organ prolapse: in these cases, hysterectomy should include associated pelvic organ supporting procedures.
– Pelvic pain when medical treatment failed
– Endometrial cancer (Uterine lining), cervical, ovarian, and fallopian tube carcinoma.
MODES OF HYSTERECTOMY
Abdominal hysterectomy (Open): In a total abdominal hysterectomy, here the doctor removes the uterus, including the cervix. The scar on the abdomen may be either horizontal incision like Caesarean section, or vertical in the midline below the umbilicus (naval).
Vaginal hysterectomy: The surgeon makes a cut in the vagina and removes the uterus through the birth canal. The incision is closed, leaving no visible scar and there is no cuts on the abdomen.
Laparoscopic hysterectomy: This surgery is done using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly or, in the case of a single site laparoscopic procedure, one small cut made in the belly button. The surgeon performs the surgery, viewing the operation on a video screen, here the complete separation of uterus from attachment is done laparoscopically. Laparoscopic hysterectomy is currently safe, efficient, less traumatic, better satisfaction rate and accepted method alternate to open surgery.
Laparoscopic hysterectomy is more advanced techniques which requires precise surgical skills, laparoscopy is least traumatic, small abdominal cuts so it reduces prolonged hospitalization and helps faster recovery.
Robot-assisted laparoscopic hysterectomy: This is similar to a laparoscopic hysterectomy, but here the surgeon uses a robotic system of surgical tools from outside the body. This technology allows the surgeon to use natural wrist movements and view the hysterectomy on a three-dimensional screen.