When Do Women Need A Hysterectomy?
A hysterectomy is a surgical procedure that involves the removal of a woman’s uterus. This may include the removal of the fallopian tubes and ovaries as well. There are several indications for a hysterectomy. Uterine fibroids are noncancerous growths that can develop in the uterus, causing heavy bleeding and pelvic pain. Endometriosis is a condition in which uterine tissue grows outside of the uterus, causing pelvic pain, heavy bleeding, and infertility. There are several other indications, including uterine cancer, uterine prolapse, and gender-confirming surgery.
Types of hysterectomies
Several surgical approaches are available, including traditional, vaginal, and minimally invasive surgery like laparoscopic. Technique selection depends on factors like uterus size and shape, accessibility, extent of extrauterine disease, surgeon training, and technology availability.
What’s a traditional hysterectomy?
The surgical approach for a traditional hysterectomy or laparotomy is an open abdominal incision. Approximately 54% of hysterectomies are open. Literature analysis suggests this procedure is associated with more bleeding, GI tract, and nerve injuries than other routes, potentially increasing hospital stay and complications. However, there are fewer bladder and urologic injuries seen with this method. All surgeries have risks of deep venous thrombosis (DVT) or pulmonary embolism (PE), but these conditions following open procedures, especially in cancer patients, were observed at higher rates.
Minimally invasive options
Laparoscopic hysterectomy (LH) is a surgical procedure that enables surgeons to treat medical conditions in the abdomen and pelvis. The procedure is performed through small, keyhole incisions utilizing instruments and a camera to view the anatomical organs on a video monitor. This is a minimally invasive surgery (MIS) that results in less bleeding, trauma to the tissue, and recovery time. This surgical approach offers many benefits over traditional, more invasive methods.
1. Reduced pain and scarring with LH
Surgical pain is an unpleasant sensation associated with tissue damage and trauma. Invasive procedures that require larger incisions increase the risk of experiencing more postoperative pain and scarring. Minimally invasive procedures like LH rely on smaller incisions, less trauma to the underlying tissue, and less pain. Cosmetically, the scars are less noticeable versus a large vertical or horizontal abdominal scar from an open procedure.
2. Less surgical infection potential
Surgical site infection (SSI) is a complication of any surgery and is defined as an infection occurring within 30 days of surgery. Out of a 300-patient study, 17 SSIs were reported, 14 of which underwent the traditional approach, and 3 were operated on laparoscopically. 82.4% of infections occurred in the conventional group.
3. Better quality of life
Quality of life encompasses multiple factors, including personal health, work, and social and environmental influences that augment well-being and happiness. Anticipating surgery can engender preoperative anxiety, which can impact recovery, wound healing, and patient satisfaction. Studies show that patients undergoing LH lead a superior quality of life in the earlier stages postoperatively.
Laparoscopic hysterectomy: a superior choice
There are many indications for a hysterectomy, which vary from bleeding fibroids to endometriosis, but minimally invasive options are available. Traditionally, hysterectomies were performed open until laparoscopy was introduced. Laparoscopic hysterectomy offers smaller incisions, less pain, lower infection rates, and better quality of life. Discuss the many benefits with a healthcare provider before making that critical decision.
