Hysterectomy—Laparoscopic Surgery
(Surgical Removal of the Uterus [or Womb]; Abdominal Hysterectomy)
Definition
- Supracervical hysterectomy—removal of the uterus only
- Total hysterectomy—removal of the uterus and cervix (the opening of the uterus leading to the vagina)
- Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
- Salpingo-oophorectomy —removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)
Reasons for Procedure
- Treat cancers (eg, uterine , endometrial, ovarian cancers)
- Remove uterine fibroids
- Treat chronic pelvic pain
- Treat heavy bleeding
Possible Complications
- Reactions to anesthesia
- Pain
- Infection
- Bleeding
- Fatigue
- Injured pelvic organs (bowel and/or bladder)
- Urinary incontinence (problems controlling your urine)
- Loss of ovarian function and early menopause
- Depression
- Sexual dysfunction
- Obesity
- Smoking
- Heart or lung disease
- Diabetes
- Previous pelvic surgery or serious infection
- Use of medicines during the past month
What to Expect
Prior to Procedure
- Blood and urine tests
- Pap smear
- X-ray of abdomen and kidneys—a test that uses radiation to take a picture of structures inside the body
- Pelvic ultrasound —a test that uses sound waves to show organs in the abdomen
- Dilation and curettage (D&C)—surgical removal of tissue from the lining of the uterus
-
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as warfarin (Coumadin)
- Clopidogrel (Plavix)
- Arrange for a ride home and for help at home.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Anesthesia
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Description of the Procedure
Immediately After Procedure
How Long Will It Take?
Will It Hurt?
Average Hospital Stay
Post-procedure Care
- On the first night, the nurse will help you sit up and walk.
- During the next morning, the IV will be removed if you are eating and drinking well.
- You may need to wear special stockings or boots to help prevent blood clots.
- You may have a Foley catheter for a short time to help you urinate.
- To prevent infection, take proper care of the incision areas.
- Slowly increase your activities. Begin with light chores and short walks.
- During the first two weeks, rest and avoid strenuous activities, like heavy lifting.
- Ask your doctor when it is safe for you to return to work and drive.
- Ask your doctor when you will be able to shower, bathe, or soak in water.
- Eat a diet rich in fruits and vegetables .
-
Pain medicines can cause
constipation
. To avoid constipation:
- Eat high-fiber foods .
- Drink plenty of water.
- Use stool softeners if needed.
- Ask your doctor when you can use tampons.
- Wait six weeks before resuming sexual activity.
- Ask your doctor if you should do Kegel exercises to strengthen the pelvic floor muscles.
- Follow your doctor's instructions .
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
- Nausea and/or vomiting
- Dizziness or fainting
- Cough, shortness of breath, or chest pain
- Heavy bleeding
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Swelling, redness, or pain in your leg
RESOURCES
American Academy of Family Physicians http://www.aafp.org/
The American Congress of Obstetricians and Gynecologists http://www.acog.org/
CANADIAN RESOURCES
Canadian Medical Association http://www.cma.ca/
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/
References
Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120815T1040007858 . Published August 2011. Accessed August 16, 2012.
Hysterectomy. Bon Secours St. Francis Health System website. Available at: http://www.stfrancishealth.org/our-services-surgical-care-surgical-procedures-hysterectomy.html . Accessed August 16, 2012.
Laparoscopic supracervical hysterectomy. Shawnee Mission Medical Center website. Available at: http://videocenter.shawneemission.org/videos/laparoscopic-supracervical-hysterectomy . Accessed August 16, 2012.
McCoy K. Robot-assisted laparoscopic procedures. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 30, 2011. Accessed August 16, 2012.
The treatment: robot-assisted laparoscopic hysterectomy. UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/obgyn/specialties/robotic%5Fsurgery/hysterectomy.html . Accessed August 16, 2012.