Hysterectomy, Abdominal
Abdominal hysterectomy is a surgery that removes the uterus and cervix through an incision in the abdomen. The ovaries and fallopian tubes may or may not be removed at the same time.
Who is a candidate for the procedure?
An abdominal hysterectomy may be done for the following problems:
abnormal cells in the lining of the uterus or cervix that are suspicious for very early cancer
abnormal or heavy bleeding from the uterus
adenomyosis, or noncancerous tumors made of gland tissue and muscle
chronic pelvic pain
endometriosis, a condition in which small pieces of the uterus lining attach to tissue outside the uterus
fibroids, which are noncancerous tumors that grow in the muscle of the uterus
pelvic inflammatory disease, or widespread infection of the pelvic organs
uterine prolapse, a condition in which the uterus drops from its normal position at the top of the vagina
Women may also have an abdominal hysterectomy if they suffer from certain types of cancer, such as:
cervical cancer
fallopian tube cancer, or cancer of the tubes that connect each ovary to the uterus
ovarian cancer
uterine cancer
How is the procedure performed?
Before surgery, several things are usually done.
An intravenous line, or IV, is placed in a vein, usually in the hand or arm. The IV can be used to replace fluids and give medicine or a blood transfusion.
A urinary catheter is placed in the bladder to drain urine.
An anesthesiologist meets with the woman. He or she will discuss the anesthesia options and allergies to medicines.
The abdomen and vulvar area, which is the area between the legs, are sometimes shaved.
Medicines, such as sedatives, are given.
In the operating room, the woman is given either local or general anesthesia. The skin around the vagina is cleaned with a soapy solution to remove any bacteria. A cut is then made in the lower abdomen. This exposes the tissue, such as blood vessels, that surrounds the uterus and cervix. These tissues must be cut and tied off before the uterus is removed. Sutures are placed in these deep structures. These will heal during the weeks following surgery. They do not need to be removed. The uterus is removed from the top of the vagina, and the vagina is closed at the top.
The surgery usually takes 60 to 90 minutes. At times, the ovaries and tubes may be removed. Other organs may be repaired or removed as needed.
Other steps may also be needed during the surgery if there is cancer.
Check the lymph nodes to see if cancer has spread.
Fix, alter, or remove other organs.
Remove as much cancer as possible.
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