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HYSTERECTOMY

Hysterectomy

Hysterectomy is surgical removal of the uterus. For several conditions including fibroids, endometriosis and uterine prolapse, a hysterectomy may be required when there are no other appropriate alternatives.

Because this is major surgery, other treatment options such as endometrial ablation or uterine artery embolization (UAE) may be tried prior to a hysterectomy.

What Is a Hysterectomy?

A hysterectomy is surgery to remove the uterus. A total hysterectomy includes removal of the entire uterus and cervix. This does not include removal of the ovaries or fallopian tubes. A hysterectomy can be done vaginally, abdominally or laparoscopically depending on why you are having the surgery.

Removing the uterus means you can no longer get pregnant. Some women elect less invasive options to help with their concerns initially and may wait to have a hysterectomy until they are done having children.

What To Expect During a Hysterectomy

The most common way a hysterectomy is performed is vaginally, although it can be done laparoscopically or abdominally. If needed, the ovaries and fallopian tubes may be removed at the time of hysterectomy; this procedure is called a salpingo-oophorectomy. If they appear normal at the time of surgery, the ovaries and tubes are usually left in place.

Vaginal hysterectomy — the uterus is removed through the vagina and there are no abdominal incisions which can result in fewer complications and a shorter recovery time.

Laparoscopic hysterectomy (can be performed with or without robotic assistance) — several small incisions are made in the abdomen. Then a laparoscope (a thin rod with a camera attached) as well as other instruments are inserted through these small incisions. Depending on the type of surgery, the uterus is then removed in small pieces through these incisions or sometimes through a larger abdominal incision or the vagina (laparoscopically assisted vaginal hysterectomy – LAVH). For certain conditions, a robot-assisted laparoscopic hysterectomy is recommended (see below).

Abdominal hysterectomy — the uterus is removed through a larger incision in the abdomen. This has an increased risk of complications and a longer hospital stay and recovery but may be necessary for certain conditions.

Robot-Assist Laparoscopic Hysterectomy (da Vinci® Hysterectomy)

A da Vinci® hysterectomy is a robot-assisted, minimally invasive procedure used to remove a woman’s uterus. The procedure uses unique technology known as the da Vinci Surgical System that offers the most precise hysterectomy available. A da Vinci hysterectomy enables women with complex conditions (history of multiple prior surgeries, endometriosis, or fibroids) who might otherwise have required open abdominal surgery to have a minimally invasive procedure instead.

A da Vinci hysterectomy is minimally invasive and requires only a few small incisions, providing several benefits including outpatient surgery with shorter hospital stays, a faster recovery, less pain, blood loss and scarring, fewer complications, and a lower rate of converting to open surgery.

The robot technology also allows surgeons to use surgical instruments that offer the precision and flexibility needed to perform complex, delicate hysterectomies – procedures that can be extremely difficult with traditional laparoscopic surgery instruments.

How It Works
In a da Vinci hysterectomy, the surgeon performs the procedure with the help of thin robotic arms inserted into small, 8mm incisions. These robotic arms replicate the exact movements of the surgeon’s hands, wrists and fingers and every movement is controlled by the surgeon sitting at a console a few feet away from the patient. The surgeon can move tiny instruments inside the patient with greater dexterity, precision and control than possible with the human hand. The system uses a camera with 3D high-definition views, giving your surgeon a crystal-clear view of the surgical area magnified 10 times what the human eye sees.

Recovery After Traditional Hysterectomy

After surgery, you will need to stay in the hospital for a few days to help with pain management and monitor for complications. The exact length will be determined by what and how the procedure was done. Common post-operative symptoms include mild pain, fatigue, constipation, light vaginal bleeding/discharge. It is important to follow your surgeon’s recommendations to ensure the best and fastest recovery time possible.

You will be restricted from lifting anything more than 10 pounds for approximately 4-6 weeks. You should not put anything inside the vagina for 6 weeks. Please call our office if you experience fever, heavy vaginal bleeding, severe pain, leg pain/swelling, or problems with urination.

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