Hysterectomy (removal of uterus )
Hysterectomy is the surgical removal of the womb (uterus), with or without the cervix. The operation may also be with or without the removal of the ovaries and the fallopian tubes. The uterus is a muscular organ of the female body, shaped like an upside-down pear. The lining of the uterus (the endometrium) thickens and, after ovulation, is ready to receive a fertilised ovum (egg).
If the ovum is unfertilised, the lining comes away as bleeding. This is known as menstruation (period). If the ovum is fertilised, the developing baby is nurtured inside the uterus throughout the nine months of pregnancy. If a woman has a hysterectomy, she will no longer have menstrual periods or be able to have a child, and will not need to use contraception.
The operation may be performed via an incision (cut) in your lower abdomen (abdominal hysterectomy), three to four small incisions in your abdomen (laparoscopic hysterectomy), or through your vagina (vaginal hysterectomy).
For an abdominal hysterectomy, the surgeon usually makes a horizontal cut along your pubic hairline (your pubic hair may have been shaved around the incision). For most women, this leaves a small scar. Some women may need a vertical midline incision in the lower abdomen, especially if the hysterectomy is for a large uterine fibroid. An abdominal hysterectomy is generally recommended when a woman has very large fibroids or cancer.
For a laparoscopic hysterectomy, the surgeon inserts a telescope (laparoscope) to see your pelvic organs through a small incision in your navel, and makes another three or four small incisions through which other instruments are used. Carbon dioxide gas is used to distend (inflate) your abdomen, like a balloon, so all of your organs can be clearly seen. The surgeon then removes the uterus, with or without fallopian tubes and ovaries, through the vagina. If the top of the vagina is sutured (stitched) through keyhole incisions, the operation is called a total laparoscopic hysterectomy. If the gynaecologist stitches the top of the vagina through the vagina, it is called a laparoscopically assisted vaginal hysterectomy.
A vaginal hysterectomy is performed through an incision at the top of the vagina. It is usually performed where there is a uterine prolapse (the cervix and uterus come down into the vagina, or protrude out of the vaginal entrance).