Abdominal Hysterectomy
Definition
It is a surgical procedure that involves the removal of the uterus. Sometimes it may be accompanied by resection of the fallopian tubes and ovaries. Procedure is called Salpingo Oophorectomy.
Types
- Total: The entire uterus is removed, including the cervix. It can be with uni or bilateral salpingo-oophorectomy.
- Radical: In which the upper part of the uterus is removed and the cervix is left in place.
- Subtotal: The entire uterus, lymph nodes and supporting structures surrounding the uterus are removed.
Indications
- Abnormal uterine bleeding
- Chronic pelvic pain
- Adenonomyosis
- Endometriosis
- Uterine fibroids
- Chronic pelvic disease
- Uterine fibroids
- Pelvic organ prolapse
- Gynecological cancer
Type of surgical approach
This is performed according to:
- The indication for surgery.
- The need for exposure, according to the size and mobility of the uterus.
- The need to increase the size of the incision.
- Surgeries Previous surgical scars.
Description
Vaginal
The uterus is removed through the vagina
Advantages
Scars are not visible
- Compared to abdominal surgery
- Shorter procedure
- Shorter hospitalization
- Faster resumption of normal activities
- Fewer infections
- Less pain
Disadvantages
It is not always possible if adhesions are present or the uterus is very large.
Description
Abdominal
The uterus is removed through an incision in the lower abdomen.
Advantages
- It can be done if there are adhesions
- It can be done if the uterus is large
- Good visualization for the surgeon
Disadvantages
Compared to vaginal or laparoscopic surgery
- Longer hospital stay
- Larger incision
- Longer healing time
Description
Laparoscopic
A laparoscope and other instruments are introduced through small incisions in the abdomen.
Advantages
Compared to abdominal surgery:
- Smaller scars
- Shorter hospitalization
- Fewer infections
- Less blood loss
Disadvantages
Compared to abdominal surgery:
- Longer procedure
- Increased risk of injury to the urinary tract
Description
Laparoscopic Vaginal Hysterectomy (LAVH)
The uterus is removed through the vagina.
Advantages
Same as with laparoscopic surgery.
Disadvantages
Same as with laparoscopic surgery.
Description
Robotic-assisted laparoscopic hysterectomy
A robot is attached to a camera and laparoscopic instruments to facilitate the removal of the uterus.
Advantages
Same as with laparoscopic surgery.
Disadvantages
Disadvantages
- Longer procedure than laparoscopy without a robot.
- Requires experienced surgeon.
- Requires more information about risks and benefits.
Description
Single Incision Laparoscopy
A small abdominal incision is made.
Advantages
- Same as with laparoscopic surgery.
- Only one small scar.
Disadvantages
- As with laparoscopic surgery.
- Requires an experienced surgeon.
- Requires more information about risks and benefits.
Complications
- Infection
- Hemorrhage
- Urinary tract injury
- Intestinal injury
- Pulmonary embolism