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Hysterectomy

A hysterectomy removes the uterus, which may include other structures, and a woman will not be able to get pregnant or have a menstrual period. Depending on the reason a woman gets a hysterectomy, several types and techniques of hysterectomy is done. The extent of the hysterectomy and type of procedure is determined by you and your gynecologist.

Thanks to the da Vinci surgery platform, minimally invasive hysterectomy are now available. A minimally invasive hysterectomy performed in a hospital setting, can treat and correct conditions such as:

  • chronic pelvic pain
  • uterine fibroids
  • abnormal uterine bleeding
  • endometriosis
  • uterine prolapse
  • cervical abnormalities
  • cancer

Minimally invasive hysterectomies using laparoscopic techniques are unlike open surgeries because they are performed through one or more small incisions. These procedures may also allow more women, who may not be candidates for open surgery, to have a hysterectomy.

Laparoscopic hysterectomy surgical procedures

  • use fiber optics (laparoscope) and a miniature television camera along with specialized instruments are inserted into very small incisions in the navel and abdomen or through the vagina
  • may be exploratory while others are used to remove appropriate reproductive organs
  • may utilize robotic devices like the da Vinci surgical system that permits surgeons to perform with extremely high precision, vision and a level of control unavailable with standard laparoscopic procedures.

Approaches and treatments depend upon factors such as obesity, prior abdominal surgery, scar tissue and other medical considerations.

Types of Minimally Invasive Hysterectomies

Your obgyn will recommend the best type of hysterectomy procedure depending on a number of factors related to your condition. Vaginal and laparoscopic techniques use small incisions as opposed to an abdominal hysterectomy where large incisions are made.

Vaginal Hysterectomy

A vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina. By operating through the vagina, the cervix is separated from the top of the vagina permitting the uterus and the cervix to be removed through the vaginal opening.

Since a vaginal hysterectomy has fewer complications, requires a shorter hospital stay, and allows a faster recovery when compared to the removal of the uterus through an abdominal incision (abdominal hysterectomy), your obgyn may recommend this procedure if:

  • the uterus is not greatly enlarged
  • the medical conditions are not related to cancer
  • it can be used to remove one or both ovaries as well as fallopian tubes.

This procedure is called a bilateral salpingo-oophorectomy (BSO). Some surgeons perform a Laparoscopically Assisted Vaginal Hysterectomy (LAVH) to assist with the vaginal hysterectomy procedure.  LAVH is a procedure using special laparoscopic instruments to remove the uterus and, if necessary, the fallopian tubes and ovaries. This is done because the use of a laparoscope helps the gynecologic surgeon to more easily see the uterus, ovaries, and tissues that surround these organs.

Partial or Supracervical Hysterectomy

Only the upper part of the uterus is removed in a partial hysterectomy, and the cervix is left in place. Depending on the reason for the hysterectomy, the ovaries may or may not be removed. If there is a need to lower the risk for ovarian cancer, the ovaries or fallopian tubes may be removed.

A Laparoscopic Supracervical Hysterectomy (LSH) is done to remove the uterus completely using laparoscopic instruments inserted through small incisions in the abdomen. By leaving the cervix intact and attached to the upper vagina, this procedure helps to provide better pelvic support and eliminates the need for the vagina to heal. Using specials instruments, the uterus is then removed through the small incisions in the abdomen.