For women who require a hysterectomy, St. Francis physicians offer a range of surgical options, including many minimally invasive procedures.
St. Francis Eastside has been designated as a Center of Excellence for Minimally Invasive Gynecologic Surgery by the American Association of Gynecologic Laparoscopists. Read on tolearn about hysterectomy options, then speak with a Bon Secours Medical Group OB/GYN physician to learn which option is right for you.
A hysterectomy is the surgical removal of the uterus; it is the most common non-obstetrical surgery in the United States. During a hysterectomy, there are several options for exactly which organs and structures will be removed. Your physician will help you decide which type of hysterectomy is most appropriate for you, depending on your medical history and the reason for your surgery.
- Partial hysterectomy or supracervical hysterectomy involves the removal of the uterus using only laparoscopic tools. Using these instruments, the surgeon carefully separates the uterus from the cervix and then removes the uterus through one of the small abdominal incisions, leaving the cervix in place.
- Total hysterectomy is the removal of the entire uterus and cervix
- Radical hysterectomy is the removal of the uterus, both fallopian tubes, both ovaries, and the upper part of the vagina.
Hysterectomy may be performed in a variety of ways: through an abdominal incision, a vaginal incision, laparoscopic incisions, a single incision in the belly button, or with robotic-assisted technology. With minimally invasive techniques such as the laparoscopic supracervical hysterectomy, the SILS™ hysterectomy, or the da Vinci hysterectomy, recovery time is greatly reduced. However, not all patients are candidates for these techniques.
Most patients recover completely from a hysterectomy. Removal of the ovaries along with the uterus in pre-menopausal women causes immediate menopause, and estrogen replacement therapy may be recommended. Some women worry that their sexual function will be decreased after removal of the uterus, but research has proved that sexual function after hysterectomy depends most on sexual function before the surgery. Your physician and surgeon can provide you with a recovery plan that is right for your particular situation.
A recent breakthrough in hysterectomy surgery, a SILS™ hysterectomy, is completed through a single incision hidden in a woman's belly button. The SILS™ port allows for the removal of the uterus through a small incision made in the belly button, which measures slightly smaller than the diameter of a nickel.
To perform this procedure, the surgeon inserts into the belly button a SILS™ port, a soft and flexible instrument equipped with three distinct openings that allow for the use of three surgical devices at the same time. When the surgery is complete, the port is removed, leaving one incision which may not be visible upon healing.
This procedure typically requires a one-night hospital stay and recovery typically takes two weeks. While recovery time is similar to laparoscopic hysterectomy, there is only one scar to care for.
During a laparoscopic hysterectomy, the surgeon uses specialized tools that are inserted through dime-sized incisions in the navel or abdomen. A small camera provides the surgeon with a view of the inside of the abdomen, allowing the surgeon to operate with small, laparoscopic instruments, removing tissue through the tiny incisions. As with vaginal hysterectomy, there is no large abdominal incision. This type of surgery leaves tiny abdominal scars that are about one-half inch each in length.
With minimally invasive laparoscopic hysterectomy, recovery time is dramatically reduced. Most patients spend one night in the hospital and resume normal activity in two to four weeks.
da Vinci Hysterectomy/Robotically Assisted Hysterectomy
Hysterectomy also can be performed using robotic technology, called the da Vinci Surgical System. The procedure is similar to a laparoscopic hysterectomy in that it leaves several tiny scars on the abdomen, but the uterus is removed through the vagina. During da Vinci hysterectomy, the surgeon operates from a console, using robotic instruments to make small incisions in the abdomen and insert surgical instruments that have a wide range of motion and a 3D camera. These instruments allow the surgeon to have a better view of the inside of the abdomen, along with additional precision and control.
da Vinci hysterectomy allows the surgeon better visualization of anatomy, which can be important when working around delicate and confined structures like the bladder and when performing a complex, radical hysterectomy involving adhesions from prior pelvic surgery, non-localized cancer, or an abdominal surgery.
The da Vinci hysterectomy usually requires a one-night hospital stay, allowing normal activity to resume in two to four weeks.
During a vaginal hysterectomy, the surgeon makes an incision in the vagina to remove the uterus. The incision is approximately one inch long and is made at the top of the vagina, leaving no abdominal scar. The uterus and cervix are separated from the body and removed through the vagina. It is difficult to remove ovaries with this method, as they are located higher in the pelvis and cannot always be pulled down for removal. During vaginal hysterectomy, the abdominal walls are not stretched, unlike an abdominal hysterectomy.
Laparoscopically Assisted Vaginal Hysterectomy
During this procedure, the surgeon removes the uterus and cervix through the vagina, but uses laparoscopic tools to detach the ovaries. This method allows women having a vaginal hysterectomy to also have their ovaries removed. Laparoscopically assisted vaginal hysterectomy leaves a one-inch incision at the top of the vagina, and several half-inch incisions on the abdomen.
This procedure typically requires a one to two-day hospital stay, and you can resume normal activity in approximately four weeks.
An abdominal hysterectomy requires the surgeon to cut through your lower abdomen, making a vertical or horizontal incision. The incision or bikini incision is typically four to eight inches long. Tissues of the abdominal wall are stretched and the uterus is removed. With this procedure, the surgeon can see your uterus and other organs and has more room to operate.
This procedure typically requires a three- to five-day hospital stay, and patients can expect a six-week recovery and a visible scar on the abdomen.
Candidates for Surgery
Women may require a hysterectomy if one or more of the following are present: cervical cancer, ovarian cancer, endometrial cancer, uterine fibroids, endometriosis, severe long-term vaginal bleeding that cannot be controlled by medication, severe long-term infections, and/or prolapse of the uterus.
Hysterectomy surgery can be performed at either St. Francis Downtown or St. Francis Eastside. da Vinci hysterectomies are performed only at St. Francis Downtown.
Your surgeon can help you determine which surgical option is right for you.