Benign Conditions

Hysterectomy

Traditional Hysterectomy
A hysterectomy can sometimes be performed through the vagina. But, when the uterus is large or if you have internal scarring from prior surgery or other conditions, abdominal hysterectomy is usually performed.

Traditionally, abdominal hysterectomies are performed with open surgery, which requires a wide incision below the navel. This procedure can be painful, involving heavy pain medications, risk of infection and significant blood loss. After surgery, a long recovery (often six weeks) is necessary. In addition, many patients are not happy with the scar left by the incision. Minimally invasive and robotic surgery offers many improvements to this traditional approach.

Minimally Invasive and Robotic Hysterectomy
In a vaginal hysterectomy, no incisions are made on the abdomen. An incision is made in the vagina near the cervix. The uterus is taken out through the vagina and then the incision is stitched up.

In a laparoscopic hysterectomy, a laparoscope, an instrument with a thin, lighted tube and small camera that allows the surgeon to see the pelvic organs, is used. The surgeon will make three to four small cuts in the belly and insert the laparoscope and other instruments. The surgeon will cut the uterus into smaller pieces and remove them through the incisions.

In a laparoscopically assisted vaginal hysterectomy (LAVH), the surgeon will remove the uterus through the vagina. The laparoscope is used to guide the procedure.

In robotic surgery, small incisions are made in the abdomen, where special instruments including a 3D camera are inserted. The technology allows the surgeon to use more precise hand movements and to reduce scarring, pain, and expedite recovery.

Recovering from a hysterectomy takes time. Most women stay in the hospital from one to two days for post-surgery care. Some women may stay longer. Recovery time for abdominal surgery takes from four to six weeks. For a vaginal or laparoscopic surgery, recovery takes three to four weeks.

While hysterectomy is a relatively safe procedure, it may not be appropriate or necessary for all individuals or conditions. Alternative treatments that preserve the uterus may be available. For example, a robotic myomectomy may be an option for women with fibroids who want to preserve their fertility and/or uterus. Always ask your doctor about all treatment options, as well as their risks and benefits.