A hysterectomy is removal of a woman’s uterus (womb) ending menstruation and the ability to become pregnant. Hysterectomies can be partial or complete. Dr. Nezhat specializes in minimally invasive laparoscopic removal of the uterus.
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Why A Hysterectomy May Be Needed
There are many reasons a hysterectomy may be recommended. The most common ones are:
- Fibroids and fibroid tumors
- Uterine Prolapse (the uterus protrudes into the vagina)
- Endometriosis
- Adenomyosis (uterine endometriosis)
- Cancer (ovarian, cervical or uterine)
Types of Hysterectomy
- A supracervical or subtotal hysterectomy, only the upper part of the uterus (Womb body) is removed leaving the cervix in place.
- One or both fallopian tubes as well one or both ovaries can be removed at the same time.
- A total hysterectomy removes the uterus as well as the cervix.
- A radical hysterectomy is the removal the uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is typically performed when cancer is present.
- Oophorectomy is a procedure where the ovaries may also be removed or left in place in younger patients for hormonal benefits. These cases require extensive evaluation such as the condition of the ovaries, patients age and other risk factors, such as a family history of cancer.
- Salpingectomy is the removal of the fallopian tubes at the time of hysterectomy to decrease the risk of certain types of ovarian cancers. However, it requires surgical skills to avoid compromising blood supply to the ovaries, which can result in premature ovarian failure and hormone imbalance.
Surgical Techniques
- Vaginal hysterectomy: An incision is made in the vagina and the uterus is dissected and removed. The incision is sutured, leaving no visible scar.
- Laparoscopic hysterectomy: This surgery is performed using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through small incisions made just above the pubis and the belly button. The surgeon performs the hysterectomy viewing the operation on a video screen.
- Laparoscopic-assisted vaginal hysterectomy: Using laparoscopic surgical tools, the uterus is removed through an incision in the vagina.
- Robot-assisted laparoscopic hysterectomy: This procedure is similar to a laparoscopic hysterectomy, however a robotic system affords the surgeon advanced technology using natural wrist movements and a three-dimensional view of the organs.
Benefits and Recovery
- Faster recovery
- Shorter hospital stay
- Less pain and scarring
- Lower risk of infection compared to abdominal hysterectomy
- Minimal complications
- Patients typically resume regular activity with in 1-2 weeks
- Outpatient procedure typically less than a 24 hour hospital stay