What are the different types of hysterectomy?
Hysterectomy is the surgical removal of the uterus. It is the second most commonly performed surgery in non-pregnant women.
A total hysterectomy involves the removal of the whole uterus and cervix, whereas a radical hysterectomy is the removal of the whole uterus and its adjacent tissues (ligaments), cervix and some part of the vagina. The surgeon may also remove the surrounding lymph nodes.
Who needs a radical hysterectomy?
A radical hysterectomy is performed only in selected patients with
- Cervical cancer (initial stage)
- Stage II endometrial cancer (cancer of the uterus with the involvement of the cervix)
The doctors mostly consider young women or older women with no other coexisting illness fit for the surgery. Obese women are generally avoided.
With the use of radiation therapy for cancer and conservative treatments (minor procedures), a radical hysterectomy is performed less commonly than it was performed in earlier times. Women can now opt for radiation instead of going for a radical hysterectomy. Women who do not want to attend long sessions of radiation therapy usually opt for a radical hysterectomy. Still, more than 50% of women will require a few sessions of radiotherapy even after surgery.
There are times when even radiation therapy fails to resolve cervical cancer completely or results in the recurrence of cancer. Radical hysterectomy becomes a potential rescue operation in such cases.
How is a radical hysterectomy performed?
A radical hysterectomy may be performed by several types of surgical approaches: vaginally, abdominally or laparoscopically (either traditional or robotic-assisted).
Abdominal hysterectomy: The doctor makes a large cut of about 6 to 12 inches in the lower abdomen.
Vaginal hysterectomy: The operation is performed by making a cut (incision) into the vagina.
Laparoscopic hysterectomy: This is the traditional method of a laparoscopic surgery. A long and thin tube-like camera (laparoscope) is inserted through one of several small cuts in the lower abdomen. This tube helps visualize the uterus. The uterus is then removed through either one of the incisions or the vagina.
Robotic (robotically assisted) hysterectomy: This type of hysterectomy surgery involves making small cuts in the lower abdomen and using a laparoscope. However, additionally, a robotic arm will be there to help the surgeon perform the surgery.
How long does it take to recover from a radical hysterectomy?
The length of the hospital stay after a radical hysterectomy depends on the surgical approach used and the patient’s age and general health condition.
If a vaginal or laparoscopic hysterectomy has been performed, the woman may be discharged one to four days after surgery.
If the woman had an abdominal hysterectomy, she will need to stay for four to five days in the hospital.
Follow-up may be scheduled generally within four to six weeks after the surgery. However, in most cases, it is not necessary unless there are any complications.
It generally takes about four to six weeks to recover from a radical abdominal hysterectomy, whereas healing time is faster in the case of a vaginal or laparoscopic one.
Women may begin having sexual intercourse within four to six weeks, depending upon how soon the vagina heals.
Walking can be resumed soon after, but lifting weights should be avoided for at least six weeks after surgery.
What are the complications of a radical hysterectomy?
Every major surgery comes with certain risks. A radical hysterectomy is no exception. The possible complications include
- Damage to the surrounding organs (such as the bladder, ureter, bowel and blood vessels)
- Surgical wound infection
- Abscess at the surgical wound
- Bleeding from the wound
- Bowel obstruction
- Pulmonary embolus (dislodgement of a blood clot in the artery supplying blood to the lungs resulting in sudden shortness of breath)
- Heart attack
- Pneumonia
SLIDESHOW
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Hysterectomy
A hysterectomy is a surgical procedure in which the uterus is removed. There are a variety of surgical techniques for performing hysterectomies, which include vaginal hysterectomy, total hysterectomy, laparoscopy-assisted vaginal hysterectomy (LAVH), supracervical hysterectomy, laparoscopic supracervical hysterectomy, radical hysterectomy, and oophorectomy and salpingo-oophorectomy hysterectomies.
Complications include infection, pain, and bleeding. The type of hysterectomy performed is dependent on the woman and the reason for the procedure.
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