There are five types of laparoscopic hysterectomy procedures available.
- Total Hysterectomy: Removal of the uterus and cervix.
- Supracervical Hysterectomy: Removal of the body of the uterus.
- Hysterectomy with Bilateral Salpingectomy: Removal of the fallopian tubes.
- Total Hysterectomy and Bilateral Salpingo-Oophorectomy: Removal of the cervix, both ovaries and fallopian tubes.
- Supracervical Hysterectomy and Bilateral Salpingo-Oophorectomy: Removal of both ovaries and fallopian tubes.
During a laparoscopic hysterectomy, the uterus is removed using a laparoscope, a thin tube containing a video camera. Thin tubes are inserted through small incisions in the navel and in the lower part of the abdomen. The laparoscope and other instruments are passed through these tubes in order to perform the hysterectomy. The uterus is then removed in sections through the tubes or through the vagina.
The uterus is removed through the vaginal opening. This procedure is often used in cases of uterine prolapse, or when vaginal repairs are also necessary. No external incision is made, which means there is no visible scarring. A total hysterectomy can be performed with a vaginal hysterectomy. Fallopian tubes and ovaries can also be removed with this approach if indicated.
This is a traditional open surgical procedure and is only recommended under certain circumstances. The uterus is removed through the abdomen via a surgical incision about six to eight inches long. The main surgical incision can be made either vertically, from the navel down to the pubic bone, or horizontally, along the top of the pubic hairline.
Recovery after a hysterectomy
Most patients who have a minimally invasive gynecology procedure can go home from the recovery room several hours after the completion of the hysterectomy. There is also the option to stay in the hospital overnight. Patients typically require several days of oral narcotics in addition to medications such as ibuprofen. After the first few days, most women do not have significant pain but have less energy than they normally do. It is usually about two weeks before women feel back to normal. Most women can return to work following a two-week post-operative recovery, although some need a little more time.
Recovering from an open procedure is more arduous. Patients usually remain in the hospital for two days or more and require 4-6 weeks of recovery before returning to work and normal activities.