Hysterectomy is a surgery to remove the uterus and cervix. At the time of the hysterectomy, it is up to the woman to make a decision of whether to have her ovaries and tubes removed. It is also possible to leave the cervix. All of these options will be explained to patients in detail by the physicians so that a woman can make a decision that is right for her. The reasons for a hysterectomy are numerous and include problems such as symptomatic enlarged fibroids, endometriosis, bleeding, and pain. Read more about common gynecological problems here. Obviously, this is only a choice for women who do not desire to have any children in the future.
TLH: Total laparoscopic hysterectomy
LSH: Laparoscopic supra-cervical hysterectomy
LAVH: Laparoscopic assisted vaginal hysterectomy
TAH: Total Abdominal Hysterectomy
Gynecologists of Reno offers minimally invasive hysterectomies. This means that the hysterectomy can be performed with tiny incisions. The advantage of this is that the recovery time is minimal. Women go home the same day or the next day from the surgery center. Patients also can return to work in a few weeks. Unfortunately the most common hysterectomy performed in the United States is the total abdominal hysterectomy (TAH). The physicians at Gynecologists of Reno are highly skilled to perform the latest techniques to give patients the best possible outcome.
Gynecologists of Reno offers minimally invasive hysterectomies that can be performed in several different ways. Complete laparoscopic hysterectomies (TLH) can be performed either with the da Vinci robot or with regular laparoscopy. Again, with these surgeries, the entire hysterectomy is performed with tiny incisions. The doctors will discuss these options as the decision of which type of surgery to be performed is based on the individual patient's problems and desires.
Another minimally invasive hysterectomy option is the laparoscopic assisted vaginal hysterectomy (LAVH). With this surgery most of the hysterectomy is performed with laparoscopy and the remainder of the surgery is done vaginally. The surgery can be done without laparoscopy as a vaginal hysterectomy. However, the laparoscopy allows visualization of the inside the abdomen and pelvis facilitating recognition of endometriosis, adhesions, ovarian cysts, etc.
Another option for hysterectomy is a laparoscopic supra-cervical hysterectomy (LSH). This is where the uterus is removed but the cervix is not. The uterus is removed in small pieces through a half-inch skin incision and the surgery is all performed via laparoscopy. This surgery has an excellent recovery similar to the LAVH. Down sides include the possibility of having to go back and remove the cervix because of pain, bleeding, or prolapse.
A total abdominal hysterectomy (TAH) is where the uterus is removed through a large skin incision in the abdomen. This can be a low horizontal incision as in a Cesarean section or a vertical incision from the pubic bone towards the belly button. Most are done through a low horizontal incision. The reason to do an open hysterectomy is when the surgery cannot be done safely laparoscopically. The most common reason is a uterus that is too large and extends near or beyond the belly button. Other reasons would include severe scar tissue or cancer. This requires a two to three day stay in the hospital. Patients can return to work in six weeks.
Risks of a hysterectomy include the risks of anesthesia; risks of damage to bowel, bladder, ureter, and other organs; risk of infection; risk of hemorrhage and blood transfusion; risks of nerve damage; and blood clots. Risks are higher in patients with prior abdominal or pelvic surgery or history of endometriosis or scar tissue.
If you are interested in having a hysterectomy, talk to your doctor about the option that is best for you. Remember, 99% of hysterectomies can be done thru small incisions, so if you are told that you need an open abdominal hysterectomy, get a second opinion.