Advances in technology and physician training over the last few decades have greatly expanded the options available to you if your doctor has determined that you need a hysterectomy, which is the surgical removal of the uterus.
“This generally isn’t your grandmother’s hysterectomy, or even your mother’s!” says Charles Rardin, MD, director of the Robotic Program for Women at Women & Infants Hospital and director of minimally invasive surgery for Care New England Health System. “Minimally invasive and robotic techniques have changed the landscape for women needing a hysterectomy.”
Women & Infants is the only hospital in the region to offer all five types of surgical hysterectomies, and surgeons will work with you and your primary care provider or gynecologist to determine the best option for you.
These procedures include:
- Abdominal hysterectomy – this is the traditional type of surgery and often the only option for a woman. The surgeon makes a cut from four to 16 inches long on the abdomen to access the female organs and remove them. Your hospital stay would be three to five nights, and you would be out of work for six to eight weeks recovering.
- Vaginal hysterectomy – this avoids the discomfort of an abdominal cut by removing the uterus through the vagina. This is not an option for all women, especially those with small, narrow vaginas. The hospital stay is usually one or two nights, and you would be out of work for about four weeks to recover.
- Laparoscopic hysterectomy – the specially trained surgeon makes several half-inch cuts in the abdomen. A tiny camera is put through one so he or she can see the internal organs on a video screen. Surgical instruments are put through the other cuts to operate. Laparoscopy gives the surgeon a view that is like an open stomach cut but avoids the pain and blood loss. The hospital stay is usually one or two nights, and you would be out of work for about four weeks to recover.
- Robotic hysterectomy – in an approach that is similar to laparoscopy, the robotically-trained surgeon operates through several small cuts made on the abdomen. Through each is inserted a camera and instruments attached to the surgical robot which the surgeon moves using controls at a nearby console. The instruments are more flexible than those used for traditional laparoscopy, and allow the surgeon to move the tools more freely and precisely. In addition, the robotic camera provides a three-dimensional view of the surgical field, versus the two-dimensional view provided by the laparoscopic camera. The hospital stay is usually one or two nights, and you would be out of work for about four weeks to recover.
- Single-site robotic hysterectomy – using special technology with the surgical robot, the surgeon is able to remove the uterus through one small cut in the belly button. The result is a virtually scarless hysterectomy. The hospital stay is usually one or two nights, and you would be out of work for about four weeks to recover.
Why would I need a hysterectomy?
There are several non-cancerous gynecologic conditions that could benefit from a hysterectomy. Some of these problems can cause pain, heavy bleeding, and other disabling conditions. These include:
- Fibroids – non-cancerous growths in the uterine wall
- Endometriosis – non-cancerous growths involving the uterus, tubes, ovaries and sometimes other pelvic organs
- Prolapse – the falling or slipping of the uterus
- Hyperplasia – abnormal overgrowth of the inside lining of the uterus, which may develop into cancer
- Cervical dysplasia – abnormal cervical cells that might develop into cancer