Hysterectomy is a surgery for the removal of the uterus. Depending on whether there is the removal of other organs or tissues, hysterectomy may be of different types. Radical hysterectomy is a surgery that involves the removal of the entire uterus along with its supporting tissues, cervix (the neck of the uterus), and the vagina. There may also be the removal of the nearby lymph nodes, ovaries, and fallopian tubes. In some cases, the surgeon may leave one ovary or a part of it during the surgery. This may especially be done in younger women who are not yet menopausal. Leaving an ovary in such women will allow the production of enough hormones to help prevent early menopause. Since the uterus is removed in the surgery, the operated woman will not have periods or get pregnant. Radical hysterectomy is mainly done for the treatment of advanced cancer of the uterus and/or the cervix when other treatment options, such as chemotherapy and radiotherapy, have not succeeded.
Other types of hysterectomies include:
- Total hysterectomy: This involves the surgical removal of the uterus and the cervix.
- Subtotal hysterectomy: This surgery involves the removal of the main body of the uterus without removing the cervix.
- Total hysterectomy with bilateral salpingo-oophorectomy: This surgery involves the removal of the uterus, cervix, both the ovaries, and both fallopian tubes.
How is a radical hysterectomy done?
A radical hysterectomy can be performed through any of the three approaches:
- An abdominal approach where the surgeon makes a cut on the abdomen (lower belly) for the procedure. The incision may be a vertical or horizontal bikini line incision.
- A vaginal approach that involves the removal of the uterus and other structures through the vagina
- A laparoscopic or minimally invasive approach involves very small incisions on the abdomen and the use of a laparoscope (a thin, flexible instrument with a camera and a light source).
The type of incision and approach may depend on several factors. These include the severity of the disease, The structures in the abdomen and pelvis, the age of the patient, and the presence of any underlying conditions. The surgeon needs to explore these for proper treatment.
The surgery is typically done under general anesthesia (you sleep during the procedure). The surgery generally takes 1-2 hours to complete. You will have to stay in the hospital for a few days to prevent complications. There may be a urinary catheter for several days or weeks after the procedure.
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