Hysterectomy

What does the surgery involve?

Hysterectomy can be carried out by conventional open surgery which involves making a cut across the abdomen (laparotomy), or through the vagina which involves making a cut in the vagina, or by laparoscopy which involves making four tiny cuts (about 1 cm each) in the abdomen in order to insert a telescope and some other instruments to carry out the operation.

Where possible the laparoscopic (minimally invasive), vaginal or combined approach (laparoscopic assisted vaginal hysterectomy) should be preferred to the abdominal hysterectomy. The advantages and disadvantages of laparoscopic or vaginal hysterectomy are:

• It involves a much shorter hospital stay (1 or 2 days maximum)
• It takes less time to recover from the operation (resume all activities within 2-3 weeks)
• There is less pain after the operation as the abdomen is not cut open
• The scars are very tiny and often are not seen a few months after the operation
• There may be some discomfort in the abdomen and the shoulders after surgery because of the use of gas during the operation to expand the abdominal cavity
• As with any type of operation, laparoscopic hysterectomy has a small risk of complications, such as damage to the vessels causing haemorrhage (heavy bleeding), damage to the bowel, the bladder and the ureters (tubes between the kidneys and the bladder), deep venous thrombosis (clots in the blood stream).

RCOG leaflet about abdominal hysterectomy
RCOG leaflet about vaginal hysterectomy
RCOG leaflet about laparoscopic hysterectomy