What is a Hysterectomy?

Hysterectomy is a surgical procedure which is performed to remove whole or part of a women’s uterus.

When is it performed?

The surgeon may recommend a hysterectomy if either of the following conditions is observed:

• Cancer of the uterus, ovaries, or cervix
• Abnormal uterine bleeding
• Endometriosis
• Uterine fibroids
• Uterine prolapse (sliding of uterus from its normal position into vaginal canal)

What are the common types of hysterectomy?

• Total hysterectomy : This is the most common type of procedure which involves the removal of both the cervix and uterus.
• Partial or supra-cervical hysterectomy : It involves the removal of upper portion of the uterus by keeping the cervix intact.
• Total hysterectomy with bilateral salpingo-oophorectomy : In this procedure only the cervix, fallopian tubes, uterus and ovaries are removed.
• Radical hysterectomy : It is an extensive procedure in which uterus, cervix, fallopian tubes, ovaries, upper vagina, lymph nodes and some surrounding tissue is removed.

Hysterectomy can be carried out in three different ways:

• Vaginal hysterectomy
• Abdominal hysterectomy
• Total Laparoscopic hysterectomy or Keyhole surgery
• Laparoscopically Assisted Vaginal Hysterectomy

How are the different types of hysterectomy procedures performed?

Vaginal hysterectomy

It is a surgical procedure which is done to remove the uterus through the vagina.

Surgical steps:

• The patient will be subjected to general anesthesia or regional anesthesia before the surgery.
• The pelvis is approached through the vagina, the uterus is removed and the vaginal opening is closed.

The surgery lasts for about an hour.

Abdominal hysterectomy

In this surgical procedure, the uterus is removed by making an incision in the lower abdomen.

Surgical steps:

• The patient is subjected to general anesthesia/ regional anesthesia
• The surgeon will make an incision on the lower abdomen either horizontally along the bikini line or vertically from just below the belly button to the bikini line.
• The vertical incision is mostly preferred if there are any large fibroids or any other cancers in the womb.
• After the removal of uterus from the abdomen, the vagina is closed, the incision made is stitched up.

The surgery lasts for about an hour.

Laparoscopic Surgery

This surgery is also done under general anesthesia, through 2-3 keyhole openings on the tummy. Sometimes, to retrieve the uterus, it may be necessary to open the vagina from below in which case it is known as Laparoscopically Assisted Vaginal Hysterectomy.