Hysterectomy
The female reproductive organs are made up of a womb, vagina, Fallopian tubes and ovaries. The womb is about the size of a pear. It is made of specialized muscle and lies in the pelvis between the bladder and the bowel. Hysterectomy is the removal of the womb by an operation. It may be advised for a number of reasons. Possible reasons include the following:
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Heavy or very painful periods – In some women, day-to-day life is made difficult because of heavy periods. Sometimes the heavy bleeding can cause anemia.
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Fibroids – In some women they can cause heavy or painful periods. Some fibroids are quite large and can press on the bladder to cause urinary symptoms.
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Prolapse – This is where the uterus or parts of the vaginal wall drop down. This may happen after the menopause when the tissues which support the uterus tend to become thinner and weaker.
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Endometriosis – This is a condition where the cells which line the uterus are found outside the uterus in the pelvis.
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Cancer. Hysterectomy may be advised if you develop cancer of the cervix, uterus, Fallopian tubes or ovaries.
There are different types of hysterectomy operations:
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Total hysterectomy is the operation in which your uterus and cervix are removed. The ovaries are usually left.
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Subtotal hysterectomy is when your uterus is removed but the cervix is left.
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Radical hysterectomy (also called Wertheim’s hysterectomy) is when the whole womb, cervix, Fallopian tubes and ovaries, part of the vagina and lymph glands are removed. This operation is done for cancer.
Hysterectomy Surgical Procedures
Traditionally, hysterectomies have been performed using a technique known as total abdominal hysterectomy (TAH). However, in recent years, two less-invasive procedures have been developed: vaginal hysterectomy and laparoscopic hysterectomy.
In laparoscopic hysterectomy, special surgical tools are used to operate through small incisions in the abdomen and vagina.
There are two types of laparoscopic hysterectomy:
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Laparoscopically assisted vaginal hysterectomy (LAVH)
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Laparoscopic supracervical hysterectomy (LSH).
LAVH is similar to vaginal hysterectomy, and the uterus and cervix are removed through an incision at the top of the vagina; however, the surgeon also uses a laparoscope (miniature camera) inserted into the abdomen to see the uterus and surrounding organs. Other laparoscopic tools are inserted into abdominal incisions to detach the uterus before removing it.
LSH is performed entirely through small abdominal incisions, using laparoscopic tools to remove just the uterus. Since the cervix is not removed, the uterus is detached and removed in small pieces through the incisions. No incision is made at the top of the vagina.
Both types of laparoscopic hysterectomy cause less pain and have faster recovery times than TAH and produce minimal scarring.