Abdominal Hysterectomy
Hysterectomy is the procedure of surgically removing the uterus and is considered among major surgical procedures. Abdominal hysterectomy is a surgical procedure done using traditional surgery methods. It involves the abdominal incision made by the surgeons in order to remove the uterus. Abdominal hysterectomy is an ancient procedure performed for the first time in 1843.
The method is considered invasive and risky. In some cases, it is the last resort for the patient who cannot have advanced procedures that involve a laparoscope or that are robot-assisted abdominal hysterectomy. Minimally invasive surgical techniques like laparoscopic or robot-assisted abdominal hysterectomies are available and have declined the rates of performing an abdominal hysterectomy.
Reason for choosing abdominal hysterectomy rather than advanced laparoscopic or robot-assisted abdominal hysterectomies
When the size of the uterus is large, doctors prefer choosing abdominal hysterectomy over laparoscopic or robot-assisted abdominal hysterectomies, as an enlarged uterus requires greater visualization.
When doctors see signs of chronic disease in other surrounding organs
When surgeons diagnose the health conditions of the patient, they recommend abdominal hysterectomy as it is best in your interest.
Abdominal Hysterectomy
Abdominal hysterectomy or TAH (Total abdominal hysterectomy) is also called extra fascial hysterectomy. The abdominal hysterectomy aims at removing the uterus along with its outer uterine walls.
The surgery involves sequentially cutting ligaments at a distant position from the ureters, which moves the cervix away, preventing complications. The steps of surgery are as follows:
Firstly, the uterine artery is clamped, and an incision is made on the uterine artery and cardinal ligament.
Secondly, the sacrouterine ligament is clamped at the incision made on it, along with the incision on the other side of the cardinal ligament.
Thirdly, the vesicouterine ligament is clamped and cut along with the anterior portion of the cardinal ligament.
Incisions are made on the vagina, and the uterus is removed. Further, the vagina is disinfected, and the vaginal cuff is closed.
Finally, the retroperitoneum and abdominal wall are closed.
Causes of Abdominal Hysterectomy
There are various reasons why women are advised that the must go for hysterectomy:
Gynecologic Cancer
The uterus, ovaries, and cervix cancer is treated by abdominal hysterectomy when the disease progression is so high that it cannot be treated by chemotherapy or radiation.
Endometriosis
Endometrium is the lining of tissues inside the uterus. It may excessively towards other pelvic organs, fallopian tubes, and ovaries, causing endometriosis. Patients who cannot get further medications to improve endometriosis are advised to get an abdominal hysterectomy to remove the uterus, fallopian tubes, and ovaries.
Fibroids
Chronic fibroids that cause persistent bleeding increased pressure, and pain in the pelvic region have an abdominal hysterectomy as the permanent solution.
Uterine Prolapse
When the uterus descent into the vagina due to the weakening of supportive ligaments, it causes major bowel problems, and in some conditions, the surgeon may advise having a hysterectomy.
Types of Abdominal Hysterectomy
Two major types of abdominal hysterectomy are as follows:
Partial hysterectomy:
Type of abdominal hysterectomy wherein the uterus is removed, but the cervix and other organs remain intact.
Total hysterectomy:
Type of abdominal hysterectomy wherein uterus along with cervix is removed.
Recovery after Abdominal Hysterectomy
The recovery time of abdominal hysterectomy is far greater than the of laparoscopic and robot-assisted hysterectomy. Patients undergoing abdominal hysterectomy are advised to rest for 2-3 months for complete recovery.
Complications of abdominal hysterectomy
Infection is the main complication that may arise after an abdominal hysterectomy. The infections include:
- 1. Vaginal cuff inflammation
- 2. Pelvic abscess
- 3. Infected hematoma, wound infection, and urinary tract infection.
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VTE – Venous Thromboembolism is a disorder related to blood clot formation in deep veins of the legs, thighs, and pelvis.
Genitourinary injuries: Injuries to the urinary bladder and ureters occur commonly during dissection in the vesicovaginal plane and sidewalls of the pelvis.
Gastrointestinal Tract damage
Bleeding: There is more blood loss in case of abdominal hysterectomy in comparison to other types of hysterectomy.
Nerve Injury: There is an increased risk of damage to or injury to the femoral nerve that may lead to neuropathy.
Dehiscence of Vaginal Cuff – separation of the cuff may occur after a few days or years of abdominal hysterectomy.
An increased risk of infection is associated with the following :
- 1. Operation time exceeding 3 hours
- 2. Lack of antibiotics
- 3. Certain patient factors like
- 4. Comorbid conditions
- 5. Immunocompromised status
- 6. Obesity
- 7. Poor nutrition
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Other complications arising as a result of abdominal hysterectomy are:
- 1. Pelvic prolapse
- 2. Fistula
- 3. Urinary incontinence
- 4. Intestinal ileus
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If any of these complications arise, the patient must visit the doctor and get appropriate treatment as soon as possible so that the condition does not get worse. Glamyo health provides the best consultation and experts in hysterectomy procedures.
- 1. Benefits of abdominal hysterectomy
- 2. Prevent the risk of cancer development in other organs
- 3. Improve various medical conditions like
- 4. Fibroids,
- 5. Adenomyosis
- 6. Endometriosis
- 7. Severe bleeding and pain
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Frequently Asked Questions
Why would someone get an abdominal hysterectomy?
Abdominal hysterectomy is recommended for women with the following medical issues:
- 1. Uterine prolapse
- 2. Fibroids
- 3. Endometriosis
- 4. Adenomyosis
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What happens when you have an abdominal hysterectomy?
An abdominal hysterectomy removes the uterus via an opening or incision in the abdomen or belly.
Is abdominal hysterectomy considered a major surgery?
Total abdominal hysterectomy is associated with the removal of the uterus along with other organs like fallopian tubes, ovaries and cervix. It requires a patient to remain in the hospital for a few days and take months to recover. Therefore, it is major surgery.
What happens to abdominal organs after a hysterectomy?
There is slight shifting or adjustment of the rest of the organs in the pelvis after abdominal hysterectomy. The shifting of organs may complicate many body functions, causing urinary incontinence.
How long is recovery from an abdominal hysterectomy?
Recovery time after abdominal hysterectomy is far greater than the other hysterectomy like laparoscopic, vaginal or robot-assisted hysterectomy. The complete recovery after abdominal hysterectomy requires 2-3 months of complete rest.
How long does abdominal hysterectomy take?
An abdominal hysterectomy must be performed after giving general anesthesia, and the procedure generally lasts 1-2 hours. The surgery time exceeding three hours increases the risk of infections in the body.
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