Hysterectomy is advised for several reasons such as:
• To relieve pain caused by conditions like endometriosis or adenomyosis
• To alleviate heavy menstrual bleeding
• To relieve pelvic pressure due to fibroids
• Severe prolapse
• To treat uterus and ovarian cancer
There are several types of hysterectomy procedures;
• partial or supercervical hysterectomy
• complete or total hysterectomy
• hysterectomy with bilateral salpingo-oophorectomy
• radical hysterectomy
• open hysterectomy
• a vaginal hysterectomy
• laparoscopic hysterectomy
Laparoscopic hysterectomy can treat abnormal uterine bleeding or fibroids but it may not be possible to perform this procedure on women with bigger uterus, overweight, who may have multiple previous surgeries in her lower abdomen, or usually not suitable for women with gynecologic cancer. There are many advantages of laparoscopic hysterectomy that may include:
• less blood loss
• less scarring
• less post operative pain
• faster recovery
• short hospital stay
• fewer complications
• early return to normal routine
• decreased risk of infection
• less chance of hernia
During the consultation, doctor will do proper medical assessment of the patient, physical examination, blood tests, EKG to determine whether patient is the right candidate for this procedure.
Patient will be given general anesthesia. Surgeon will make a small incision in the belly button to insert a thin probe with light and tiny camera at the end (laparoscope) that enables the surgeon to see inside the images of uterus on a monitor while performing the surgery. Then two or three incisions will be made in the lower abdomen through which special surgical instruments are placed for the removal process. Mostly women do not get their ovaries removed when they undergo a hysterectomy, they can choose either to keep cervix in place called a supra-cervical hysterectomy or remove the entire the uterus known as total laparoscopic hysterectomy. Women who have the history of pre-cancerous changes of the cervix or uterus lining should have the entire uterus removed.
Patient may require staying at the hospital at least for two to five days. Doctor will prescribe some medicines to manage post operative pain. Patient should not stay in the bed for long and should gradually resume normal activities as soon as they feel fine. Women can go back to their job depending on the nature of work and other activities within few weeks of the surgery.
Laparoscopic hysterectomy also involves risk as it can lead to premature menopause which has its own side effects. There can be some other health problems like higher risk of cardiovascular disease, bone weakening, arthritis etc with the removal of ovaries.