Hysterectomy

Hysterectomy is the surgical removal of the uterus. It is done to treat certain gynecological conditions, including childbirth complications; cancer; and fibroids, endometriosis, or uterine bleeding that hasn't responded to other treatments.

A total (complete) hysterectomy is removal of the uterus and cervix. A subtotal (also called partial or supracervical) hysterectomy is the surgical removal of the uterus, leaving the cervix in place.

A radical hysterectomy is done for some cancers. It is the removal of the uterus, cervix, ovaries, structures that support the uterus, and sometimes the lymph nodes.

The uterus can be removed through:

• An incision in the vagina (vaginal hysterectomy).
• A small incision [usually about 2 in. (5 cm) long] just at or above the pubic hairline (mini-laparotomy, or "mini-lap").
• A large incision made in the lower abdomen (abdominal hysterectomy).
• Laparoscopy, which is less invasive than other methods. In this procedure, a special viewing instrument (laparoscope) is inserted through a small incision. The uterus can then be removed through a small abdominal incision or a vaginal incision (laparoscopic assisted vaginal hysterectomy).

The ovaries may be removed along with the uterus. The decision about whether to remove or leave the ovaries is based on a woman's wishes and health issues.

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