Hysterectomy Procedures

A hysterectomy is the second most common surgical procedure among American women, second only to childbirth by cesarean section delivery.¹ An estimated one-third of all U.S. women will have a hysterectomy by age 60.² From 2000-2004, about 3.1 million hysterectomies were performed (approximately 600,000 per year).³

Summa Health System’s experienced gynecologic surgeons have performed more hysterectomies than any other hospital in Summit County. For many of our patients, we are able to offer same-day surgery. That means, barring any unforeseen consequences, the woman can go home to recover from her surgery within hours of the procedure. 

• What is a Hysterectomy?
• Reasons for a Hysterectomy
• Types of Hysterectomies
• Techniques for Hysterectomies

What is a Hysterectomy?

A hysterectomy is a surgical procedure to remove a woman's uterus (womb). The uterus is the organ that shelters and nourishes a baby during pregnancy. The entire uterus (or a portion of it) may surgically be removed. After undergoing a hysterectomy, a woman will no longer have menstrual periods and can not become pregnant.

During a hysterectomy, a surgeon also may remove a woman's fallopian tubes and ovaries. The ovaries produce eggs and hormones (such as estrogen and progesterone). The fallopian tubes guide eggs from the ovaries into the uterus. The cervix is the lower end of the uterus that attaches to the upper part of the vagina. All of these female reproductive organs are located in a woman's lower abdomen.

Conditions for Performing a Hysterectomy

A hysterectomy may be suggested by your physician if you have been diagnosed with any of the following conditions:

• Cancer of the uterus, cervix or ovaries
• Fibroids (growths found in and/or around the uterus)
• Endometriosis (a condition in which the uterine lining is found outside of the uterus) which is not cured by medicine or other surgical procedures
• Uterine prolapse (where the uterus descends down into and possibly out of the vagina)
• Adenomyosis (a condition in which the uterine lining grows into the uterine wall)
• Abnormal vaginal bleeding that persists despite treatment
• Very rarely, a hysterectomy is performed following a cesarean delivery, usually to control bleeding. While there are other methods physicians can use to control bleeding, a hysterectomy may be required in some cases.

Types of Hysterectomies

Summa surgeons perform all three types of hysterectomies including:

• Partial, subtotal or supracervical hysterectomy, which removes just the uterus, leaving the cervix attached to the vagina.
• Total hysterectomy, which removes the entire uterus and the cervix.
• Radical hysterectomy, which removes the entire uterus, the tissue on both sides of the cervix and the upper part of the vagina. This type of hysterectomy is usually conducted when cancer is present.

Surgical Techniques for Hysterectomies

There are several surgical techniques used to perform a hysterectomy including:

• Abdominal (also referred to as an "open" hysterectomy) is performed through a 5"-7" incision made in the lower part of the abdomen.
• Vaginal is performed through an incision made in the upper part of the vagina. The uterus is removed through this incision which is then closed with stitches.
• Laparoscopic is performed by making three or four small incisions in the abdomen to insert the laparoscope and other instruments. After the uterus and/or cervix are detached from the vagina, the surgeon will either remove the tissue through the vagina or through the incisions.
• Laparoscopically assisted vaginal hysterectomy (LAVH) is when the surgeon performs the initial part laparoscopically, while the remainder of the procedure is done vaginally. The uterus is removed through the vagina.
• Robotic-assisted hysterectomy is performed by a surgeon using a special machine (robot) to conduct the surgery through small incisions in the abdomen, much like a laparoscopic hysterectomy. Though called a "robot", the machine does not act on its own but is an extension of the surgeon's hands. They control the robot's actions, which translates hand movements into small, precise movements of tiny instruments inside the body. The robot's camera and lighting system also provide your surgeon with a magnified, high-definition, three-dimensional (3D) view of the surgical field.

*Minimally invasive robotic surgery may not be the best option for everyone. Your surgeon can explain all of the surgical options available for hysterectomy, including whether you’re a good candidate for minimally invasive robotic surgery.

Read more about the use of minimally invasive robotic surgery at Summa Health.
To schedule an appointment, please call 330.375.4094

Sources:

1 Hysterectomy fact sheet. (n.d.). Retrieved August 27, 2012, from womenshealth.gov:http://womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.cfm
2 “Hysterectomy”. Medline Plus; A Service of the U.S. National Library of Medicine – National Institutes of Health. Available from:http://www.nlm.nih.gov/medlineplus/hysterectomy.html
3 Choosing the Route of Hysterectomy for Benign Disease, American College of Obstetricians and Gynecologists. Retrieved September 7, 2012, from the ACOG website here.