Types of hysterectomy
- Radical hysterectomy: complete removal of the uterus, cervix, upper vagina, and parametrium. Indicated for cancer. Lymph nodes, ovaries and fallopian tubes are also usually removed in this situation.
- Total hysterectomy : Complete removal of the uterus and cervix
- Subtotal hysterectomy: removal of the uterus, leaving the cervix in place.
Techniques of Hysterectomy
A hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac. This can allow a loop of intestine or abdominal tissue to push into the sac. The hernia can cause severe pain and other potentially serious problems that could require emergency surgery.
Abdominal Hysterectomy Abdominal Hysterectomy is the oldest techniques of uterus removal whereby the approach is made through horizontal or vertical incision of about 5 to 7 inches. This technique is used for radical hysterectomy as the long incision allows complete access to the reproductive complex. The incision is generally made just above the pubic bone to make it as inconspicuous as possible, but since it involves cutting of the muscles, the recovery time is long, complete recovery may take as long as 6 months.
Vaginal Hysterectomy- Vaginal hysterectomy involves removal of uterus through the vaginal canal. It is done by making a small circular incision in the upper part of the vagina. It was an improvement over abdominal hysterectomy, since it involved smaller incision and shorter recovery. Vaginal hysterectomy is advised in case of uterine prolapse
Laparoscopic Assisted Hysterectomy
Laparoscopic Assisted Hysterectomy is a modern minimally invasive technique with lesser post-operative complications and rapid recovery for the patient.
Total Laparoscopic Hysterectomy This is an advanced technique which entails making 3-4 incisions near the umbilicus. A laparoscope is then inserted through one of the incisions which allows surgeon to view pelvic cavity. The surgeon uses tiny instruments to cut the uterus into small pieces, which are removed through these small incisions in the abdomen.
Laparoscopic Vaginal Hysterectomy This technique entails inserting a laparoscope through 2-3 small incisions close to the umbilicus, using the laparoscope to detach the uterus and removing it through the vagina.
Laparoscopic Supracervical Hysterectomy This technique entails removes the uterus without removing the cervix using a morcellator which cuts the uterus into small pieces that can be removed from the abdominal cavity via the laparoscopic ports.
Robotic Laparoscopy Hysterectomy Robotic laparoscopic hysterectomy is the most advanced and the latest technique which uses a special remote controlled robotic instrument for hysterectomy. The advantages of robotic surgery include finer control and precision over the other techniques