Wertheim’s Hysterectomy – Wertheim was a physician, the pioneer in the Radical hysterectomy or radical total hysterectomy wherein the pelvic region’s lymph nodes and the parametrium was removed. Wertheim was the one who took the initial step in the standardization of total radical hysterectomy and developed a safer and more feasible surgical operation to treat various medical complications in women, along with cervical cancer.

Wertheim Hysterectomy

In Wertheim’s hysterectomy, the basic technique of radical hysterectomy (the removal of the uterus, cervix, ovaries, and fallopian tubes along with other nearby tissues) was improvised and developed. Wertheim’s hysterectomy procedure describes the approaches that reduced the problems associated with haemorrhage, sepsis, injury to the urinary tract, and fistula formation. 

  • 1. Hallmarks of Wertheim’s hysterectomy 
  • 2. Careful asepsis
  • 3. Rapid completion of the surgery 
  • 4. Minimal blood loss
  • 5. Careful handling of vital surrounding organs 
  • 6. Consideration of the heart

Risk of Cancer Even after having a Hysterectomy

Cancer development depends on the type of hysterectomy procedure performed. There is a risk of ovarian cancer if the ovaries are not removed in the hysterectomy procedure. There are studies showing a gradual increase in the risk of colorectal cancer after bilateral oophorectomy. 

Why is a Hysterectomy Bad?

Hysterectomy is bad as it involves the removal of an essential organ of the female body. There are a lot of physical changes in the body, along with major emotional disturbances due to altered hormonal levels. 

Impact of Wertheim’s Hysterectomy

Ernst Wertheim was an Austrian surgeon who developed the successful treatment strategy of hysterectomy. Addressing the challenges like excessive blood loss and perioperative infections in the era where blood transfusions and antibiotics were not available was a major advancement in the history of abdominal hysterectomies. 

According to research outcomes from 500 patients who underwent surgeries, absolute accomplishments were achieved. All patients were alive, and they did not report any disease or recurrence post-surgery, even after their 5-year follow-up. 

Modifications of Wertheim’s Hysterectomy

Modifications in the surgical procedure of Wertheim’s Hysterectomy were introduced by Shouhei Takayama, who was a Japanese surgeon. He paid major attention to extended parametrium resection as Wertheim’s hysterectomy described no such specifications for the boundaries of the resecting parametrium. 

Another modification introduced by Takayama’s student was a novel technique to separate the posterior portion of the vesicouterine ligament. The technique was beneficial as it enhanced the perirectal and perivesical space allowing for extended vaginal resection. 

Further modifications were also introduced that came to be known as the Wertheim – Meigs hysterectomy procedure with the resection of only those lymph nodes that seem to be enlarged or found to be cancerous. 

Frequently Asked Questions

Which is the least invasive procedure for a hysterectomy?

A minimally invasive surgical hysterectomy is the best option to opt for. The hysterectomy procedures that are minimally invasive include laparoscopic hysterectomy and vaginal hysterectomy.

In which type of hysterectomy almost all the organs near the womb are removed?

Radical hysterectomy is a type of hysterectomy wherein the womb, and associated organs are also removed, like vaginal portions, fallopian tubes, ovaries, fatty tissues, and lymph nodes. 

What are the after-effects on a woman’s body post hysterectomy?

As the uterus is removed in a hysterectomy, the woman does not have periods anymore, and there are severe hormonal fluctuations. Some of the other after-effects on a woman’s body are:

  • 1. Pain
  • 2. Bleeding
  • 3. Vaginal discharge
  • 4. Constipation
  • 5. Hot flashes

How much blood is lost from the body during a hysterectomy?

The hysterectomy procedure may lead to 50-100 ml (millilitres) of blood loss. The amount of blood that a woman loses from her body after a hysterectomy depends upon the procedure opted for the hysterectomy and the type of hysterectomy performed. 

Advanced and minimally invasive procedures lead to lesser loss of blood in comparison to the traditional methods of surgery. The loss of blood is more in the case of abdominal hysterectomy as compared to vaginal hysterectomy. 

In which type of hysterectomy does menstrual bleeding stop?

The menstrual bleeding stops after a hysterectomy of any kind. Mild bleeding for some time may occur if there is some lining of the cervix shedding.

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