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Hysterectomy: The Why, When, and How.

  • Paul E. Evans MD

Hysterectomy is the 2nd most common surgery among women in the USA. A hysterectomy is an operation to remove a woman's uterus. A woman may have a hysterectomy for different reasons, including:

  • Uterine fibroids that cause pain, bleeding, or other problems
  • Uterine prolapse, which is a drop of the uterus from its normal position into the vaginal canal
  • Cancer of the uterus, cervix or ovaries
  • Endometriosis
  • Abnormal vaginal bleeding
  • Chronic pelvic pain
  • Adenomyosis, or a thickening of the uterus

Hysterectomy is usually considered only after all other treatment approaches have been attempted without success. When you have tried other medical or less invasive treatments then hysterectomy may be the best solution for your problem.

Hysterectomy is performed in several ways.

There are different ways that your doctor can perform a hysterectomy. It will depend on your health history and the reason for your surgery.

  • Abdominal hysterectomy. This is done through a 5- to 7-inch incision. The cut may go either up and down, or across your abdomen. This approach requires longer hospitalization and recovery.
  • Vaginal hysterectomy. This is done through an incision in the vagina. The doctor will take your uterus out through this incision and close it with stitches.
  • Laparoscopic hysterectomy. A laparoscope is an instrument with a thin, lighted tube and small camera that allows your doctor to see your pelvic organs. Your doctor will make three to four small cuts in your belly and insert the laparoscope and other instruments. Then the uterus can be removed through the incisions or through the vagina (LAVH).
  • Robotic-assisted surgery. The use of the robotic device allows for better visualization and greater instrument dexterity. This allows us to accomplish more difficult procedures minimally invasively.

Our practice encourages a minimally invasive approach to hysterectomy to improve the patient’s outcome and allow faster recovery with less pain and blood loss.

Since 1990 our practice has been performing advanced laparoscopic surgeries including hysterectomies. Since 2010 we have been performing robotic-assisted laparoscopic surgeries. This has allowed us to decrease the need for open surgeries. In our local community, open approaches are still highly utilized at 60 -80%. Presently 91% of the surgeries Women’s Specialty Care physicians perform are minimally invasive. We continually strive to improve patient outcomes with less down time by encouraging the latest advances in care and technology. We were the first group to perform robotic hysterectomy in Central Georgia.

If you are considering hysterectomy it is vital that you consider all treatment options and techniques available to resolve your problem and help you recover and resume your life activities as soon as possible.

Below is a graph of the percentages of different hysterectomy types that Women's Specialty Care has performed.