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Hysterectomy -- Laparoscopic Surgery

Click here to view an animated version of this procedure.

Definition

Hysterectomy is the surgical term for the removal of the uterus (womb). This results in the inability to become pregnant.

There are different types of surgeries, such as:

  • Supracervical hysterectomy—removal of the uterus only
  • Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
  • Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
  • Salpingo-oophorectomy —removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

Reasons for Procedure

You may have a hysterectomy if your uterus is causing health problems that cannot be treated by other means. Some reasons a woman may have a hysterectomy are to:

Explore your options before having a hysterectomy. There are other treatments for many of these problems.

Possible Complications

If you are planning to have hysterectomy, your doctor will review a list of possible complications, which may include:

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

The following may also increase the risk of complications:

  • Diabetes
  • Previous pelvic surgery or serious infection
  • Use of certain medications

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Blood and urine tests
  • Pap smear
  • X-ray of abdomen and kidneys—a test that uses radiation to take a picture of structures inside the body
  • Pelvic ultrasound —a test that uses sound waves to show organs in the abdomen
  • Dilation and curettage (D&C)—surgical removal of tissue from the lining of the uterus

You should do the following:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs such as ibuprofen and naproxen
    • Blood thinners
    • Anti-platelet medications
  • Arrange for a ride home and for help at home.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be used. You will be asleep during the surgery.

LAVH
Laparoscopic hysterectomy
Copyright © Nucleus Medical Media, Inc.

Description of the Procedure

You may be given antibiotics just before your surgery.

Laparoscopic procedures are minimally invasive. This means that small incisions are made, rather than the large incisions that are used during open surgery.

Laparoscopic Supracervical Hysterectomy

During this procedure, small incisions will be made in the area of your navel and hip bone. A laparoscope (a small instrument with a camera on one end) will be inserted through one of the incisions. The instrument will allow your pelvic organs to be viewed on a monitor. Other instruments will also be inserted to do the surgery. Next, the uterus will be detached from the cervix. A tool will be used to break down the uterus into smaller pieces. This tissue will be removed through the small incisions.

Laparoscopic-Assisted Vaginal Hysterectomy

Similar to the above surgery, small incisions will be made in the abdominal area and tools will be inserted. Incisions will be made in the vagina to help detach the lower portion of the cervix and the uterus. The cervix and uterus will then be removed through the vaginal opening.

Robot-Assisted Hysterectomy

A hysterectomy can also be done using robotic technology. Like the laparoscopic procedures, tools are placed through small incisions in the abdominal area. The doctor, though, sits at a console and views the organs via a monitor that displays a 3D image. The surgery is done using a joystick-like device to control the tools.

Immediately After Procedure

You will be given IV fluids and medications.

How Long Will It Take?

1-3 hours

Will It Hurt?

You will not have pain during the surgery because of the anesthesia. During your recovery time, you will be given pain medication.

Average Hospital Stay

You may be able to leave the hospital on the same day or the next day. You will stay longer if you have complications.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

  • On the first night, the nurse will help you sit up and walk.
  • During the next morning, the IV will be removed if you are eating and drinking well.
  • You may need to wear special stockings or boots to help prevent blood clots.
  • You may have a Foley catheter for a short time to help you urinate.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home

During the first few days, you may have pain, bloating, vaginal bleeding, and vaginal discharge.

When at home, take these steps to care for yourself:

Note: If the doctor has not removed your cervix, you will need to continue to have Pap smears to check for cervical cancer.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
  • Nausea and/or vomiting
  • Lightheadedness
  • Cough, shortness of breath, or chest pain
  • Heavy bleeding
  • Pain that you cannot control with the medications you have been given
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Swelling, redness, or pain in your leg

In case of an emergency, call for medical help right away.

Revision Information

  • American Academy of Family Physicians

    http://www.familydoctor.org

  • The American Congress of Obstetricians and Gynecologists

    http://www.acog.org

  • Canadian Medical Association

    http://www.cma.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120815T1040007858. Published August 2011. Accessed January 7, 2014.

  • Hysterectomy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 19, 2013. Accessed January 7, 2014.

  • Laparoscopic supracervical hysterectomy. Shawnee Mission Medical Center website. Available at: http://videocenter.shawneemission.org/videos/laparoscopic-supracervical-hysterectomy. Accessed January 7, 2014.

  • The treatment: robot-assisted laparoscopic hysterectomy. UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/obgyn/specialties/robotic%5Fsurgery/hysterectomy.html. Accessed January 7, 2014.