location: Transition > Hysterectomy > Procedure
There are four main types of hysterectomies: abdominal hysterectomy, vaginal hysterectomy, laparoscopic hysterectomy, and laparoscopic-assisted vaginal hysterectomy. I had a laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (LAVH and BSO), which removed my uterus, ovaries, fallopian tubes, and cervix.
This is the most common type of hysterectomy. During an abdominal hysterectomy, the doctor removes the uterus, including the cervix. The incision is usually 4-6 inches and may be horizontal or vertical, depending on the reason the procedure is performed and the size of the area being treated. An abdominal hysterectomy allows the whole abdomen and pelvis to be examined and gives the surgeon more room to work, but the large incision usually requires a more lengthly recovery time. Abdominal hysterectomies take between one and three hours. The hospital stay is three to five days. It takes four to eight weeks to return to normal activities.
In this procedure, an incision is made near the top of the vagina, where the surgeon can reach through and cut away the uterus from the fallopian tubes. Once it is cut free, the uterus is removed through the vagina. This technique leaves no visible scar and recovery time is generally less than an abdominal hysterectomy. However, if a person has too large a uterus, cannot have their legs raised in the stirrup device for prolonged periods, or has other reasons why the whole upper abdomen must be further examined, the doctor will usually recommend an abdominal hysterectomy. In addition, it is more difficult to see the surrounding tissues through the vaginal incision, which makes complications more common. The operation takes one to two hours. The hospital stay is usually one to three days. It takes about four weeks to return to normal activities.
Laparoscopic-Assisted Vaginal Hysterectomy -- My Procedure
During LAVH, several small incisions are made in the abdominal wall through which slender metal tubes known as "trocars" are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope, usually inserted through the navel, is attached to a camera that provides a continuous image that is magnified and projected onto a television screen for viewing. The uterus is detached from the ligaments that attach it to other structures in the pelvis using the laparoscopic tools. If the fallopian tubes and ovaries are to be removed, they are also detached from their ligaments and blood supply. The organs and tissue are then removed through an incision made in the vagina. LAVH can be a longer operation and more expensive than a vaginal hysterectomy and, under certain circumstances, it can be more dangerous. However, the incisions in an LAVH are relatively small. The scars, pain, and recovery time from LAVH are usually significantly less than with an abdominal hysterectomy. Hospital stay is usually only one day. Recovery time is about two weeks.
This procedure is similar to the Laparoscopic-Assisted Vaginal Hysterectomy, except that the organs are removed through the laparoscopic incisions in small pieces, instead of through the vaginal incision.