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Pelvic laparoscopy	Hysterectomy	Uterus	Hysterectomy - series

Hysterectomy

Definition

A hysterectomy is surgery to remove a woman's uterus. It may be done through an incision (cut) in either the abdomen (belly) or the vagina.

Alternative Names

Vaginal hysterectomy; Abdominal hysterectomy; Supracervical hysterectomy; Radical hysterectomy; Removal of the uterus; Laparoscopic hysterectomy; Laparoscopically assisted vaginal hysterectomy; LAVH; Total laparoscopic hysterectomy; TLH; Laparoscopic supracervical hysterectomy; Robotically assisted hysterectomy

Description

Your doctor will help you decide which type of hysterectomy is best for you. It will depend on your medical history and the reason for your surgery.

• Abdominal hysterectomy: The surgeon makes a 5-inch to 7-inch incision (cut) in the lower part of your belly. The cut may go either up and down, or it may go across your belly, just above your pubic hair (a bikini cut).
• Vaginal hysterectomy: The surgeon makes a cut in your vagina. Your uterus will be taken out through this cut. The cut in your vagina will be closed with stitches.
• Laparoscopic hysterectomy: A laparoscope is a narrow tube with a tiny camera on the end. Your surgeon will make 3 to 4 small cuts in your belly. The laparoscope and other surgical instruments will be inserted through the other cuts. Your uterus will be cut into smaller pieces that your surgeon will remove through the small cuts.
• Laparoscopically assisted vaginal hysterectomy: Your surgeon will remove your uterus through a cut inside your vagina. Your surgeon will also insert a laparoscope and other instruments into your belly through 2 or 3 small cuts.
• Robotic surgery is like laparoscopic surgery, but a special machine is used. It is most often used when a patient has cancer or is very overweight and vaginal surgery is not safe. See also: Robotic surgery

During a hysterectomy, the whole uterus or just part of it may be removed. The fallopian tubes (the tubes that connect the ovaries to the uterus) and ovaries may also be removed.

• A partial (or supracervical) hysterectomy is removal of just the upper part of the uterus. The cervix is left in place.
• A total hysterectomy is removal of the entire uterus and the cervix.
• A radical hysterectomy is the removal of the uterus, the tissue on both sides of the cervix (parametrium), and the upper part of the vagina. This is done mostly when some cancers are present.

Risks

The risks for any surgery are:

• Allergic reactions to medicines
• Breathing problems
• Blood clots in your leg or pelvic veins that may travel to your lungs. These can be fatal.
• Bleeding
• Infection

Risks that are possible from a hysterectomy are:

• Injury to nearby organs, including the bladder or blood vessels
• Injury to bowels
• Pain during sexual intercourse
• Early menopause, if the ovaries are removed also

Review Date: 2/19/2009
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.