For women who require a hysterectomy, St. Francis physicians offer a
range of
surgical options, including minimally-invasive procedures such as da Vinci hysterectomy
and laparoscopic supracervical hysterectomy. Speak with a Greenville or Upstate, SC area St. Francis physician to learn more
about treatment options.
Candidates for Surgery
A
hysterectomy is the surgical removal of the uterus and is the most common non-obstetrical
surgery in the United States. During a hysterectomy, there are several options
for exactly which organs and structures will be removed. Your physician will help
you decide which type of
hysterectomy is most appropriate for you, depending on your medical history and the reason
for your surgery.
- Partial hysterectomy is the removal of just the upper portion of the uterus,
leaving the cervix and base of the uterus in tact.
-
Total hysterectomy is the removal of the entire uterus and cervix
-
Radical hysterectomy is the removal of the uterus, both fallopian
tubes, both ovaries, and the upper part of the vagina.
Hysterectomy may be performed in a variety of ways: through an abdominal incision,
a vaginal incision, laparoscopic incisions, or with robotic-assisted technology.
With minimially-invasive techniques, such as the laparoscopic supracervical hysterectomy
or the da Vinci hysterectomy, recovery time is greatly reduced. However, not
all patients are candidates for these techniques.
Most patients recover completely from a hysterectomy. Removal of the ovaries
along with the uterus in pre-menopausal women causes immediate menopause, and
estrogen replacement therapy may be recommended. Some women worry that their sexual
function will be decreased after removal of the uterus, but research has proved
that sexual function after hysterectomy depends most on sexual function before
the surgery.
Your physician and surgeon can provide you with a recovery plan that is right for your particular situation.
Vaginal Hysterectomy
During a vaginal hysterectomy, the surgeon makes an incision in the
vagina to remove the uterus. The incision is approximately one inch long and is
made at the top of the vagina, leaving no abdominal scar. The uterus and cervix
are separated from the body and removed through the vagina. It is difficult to
remove ovaries with this method, as they are located higher in the pelvis and
cannot always be pulled down for removal. During vaginal hysterectomy, the abdominal
walls are not stretched, unlike an abdominal hysterectomy.
This procedure typically requires a one to three-day hospital stay,
and you can resume normal activity in approximately four weeks.
Laparoscopic Hysterectomy
During a laparoscopic hysterectomy, the surgeon uses specialized tools
that are inserted through dime-sized incisions in the navel or abdomen. A small
camera provides the surgeon with a view of the inside of the abdomen, allowing
the surgeon to operate with small, laparoscopic instruments, removing tissue through
the tiny incisions. As with vaginal hysterectomy, there is no large abdominal
incision. This type of surgery leaves tiny abdominal scars that are about one-half
inch each in length.
With minimally-invasive laparoscopic hysterectomy, recovery time is
dramatically reduced. Most patients spend one night in the hospital and resume
normal activity in two to four weeks.
There are three types of Laparoscopic Hysterectomies:
-
Total Laparoscopic Hysterectomy
The surgeon removes both the uterus and the cervix using only laparoscopic
tools.
-
Laparoscopically Assisted Vaginal Hysterectomy
During this procedure, the surgeon removes the uterus and cervix
through the vagina, but uses laparoscopic tools to detach the ovaries. This method
allows women having a vaginal hysterectomy to also have their ovaries removed.
Laparoscopically assisted vaginal hysterectomy leaves a one-inch incision at the
top of the vagina, and several half-inch incisions on the abdomen.
-
Laparoscopic Supracervical Hysterectomy
In this procedure, the uterus is removed using only laparoscopic
tools. Using these instruments, the surgeon carefully separates the uterus from
the cervix and then removes the uterus through one of the small abdominal incisions,
leaving the cervix in place.
da Vinci Hysterectomy/Robotically Assisted Hysterectomy
Hysterectomy also can be performed using robotic technology, called
the
da Vinci Surgical System. The procedure is similar to a laparoscopic hysterectomy in that it leaves several
tiny scars on the abdomen, but the uterus is removed through the vagina. During
da Vinci hysterectomy, the surgeon operates from a console, using robotic instruments
to make small incisions in the abdomen and insert surgical instruments that have
a wide range of motion and a 3D camera. These instruments allow the surgeon to
have a better view of the inside of the abdomen along with additional precision
and control.
da Vinci Hysterectomy allows the surgeon better visualization of anatomy, which can be important when
working around delicate and confined structures like the bladder and when performing
a complex, radical hysterectomy involving adhesions from prior pelvic surgery,
non-localized cancer, or an abdominal hysterectomy.
The da Vinci Hysterectomy usually requires a one-night hospital stay,
allowing normal activity to completely resume in two to four weeks.
Abdominal Hysterectomy
An abdominal hysterectomy requires the surgeon to cut through your
lower abdomen, making a vertical or horizontal incision. The incision or “bikini
cut” can be 4-8 inches. Tissues of the abdominal wall are stretched and the uterus
is removed. With this procedure, the surgeon can see your uterus and other organs
and has more room to operate.
This procedure typically requires a three to five-day hospital stay,
and patients can expect a six-week recovery and a visible scar on the abdomen.
For more information on hysterectomy options like the robotically-assisted da
Vinci hysterectomy or the minimally-invasive laparoscopic supracervical hysterectomy,
speak with a Greenville or Upstate, SC area St. Francis physician who performs
these procedures. Your surgeon can help you determine which surgical option is
right for you.