A hysterectomy is surgery performed to remove the uterus from a woman's body. The surgery can be performed through an incision in either the vagina or the abdomen. Some other terms referring to hysterectomy surgery include: robotic hysterectomy, laparoscopic surgery, Da Vinci robot surgery and laparoscopic hysterectomy. The right type of surgery depends upon the specific conditions and medical history of the patient and should be determined by a doctor.
Abdominal or Laparoscopic
For an abdominal hysterectomy, the surgeon makes a 5 to 7 inch incision in the lower belly, just above the pubic hair. This cut may be either horizontal or vertical. A vaginal hysterectomy requires a cut in the vagina and the uterus is taken out through the incision. The incisions will then be closed with stitches. A laparoscopic hysterectomy is performed with a laparoscope, which is a narrow tube that has a tiny camera on its end. The surgeon makes 3 to 4 small cuts in the abdomen, and the laparoscope and other necessary surgical instruments are inserted through the incisions. The uterus is then cut into smaller pieces that allow your surgeon to remove it through the other incisions. For a laparoscopically assisted vaginal hysterectomy, the surgeon will remove the uterus via a small cut inside of the vagina. The surgeon will insert a laparoscope and other instruments into the belly to perform the procedure through 2 to 3 small cuts.
Robotic surgery is similar to laparoscopic surgery, however a special machine is used, such as the Da Vinci robot. This procedure is most often used when a patient is very overweight, has cancer, or vaginal surgery is not safe for any other reason.
What is Removed?
The whole uterus or just part of it can be removed. The fallopian tubes (tubes that connect ovaries to the uterus) and also the ovaries may be surgically removed during the procedure:
• Total hysterectomy: the removal of the entire uterus as well as the cervix
• Partial (supracervical) hysterectomy: removal of just the upper part of the uterus, leaving the cervix in place
• Radical hysterectomy: removal of the uterus, the tissue on both sides of the cervix as well as the upper part of the vagina. (This type is done most often done when cancer is present.)