A hysterectomy is the removal of the uterus. The uterus can be removed by a lower abdominal incision (open surgery). The uterus can sometimes be removed through the vaginal canal (vaginal surgery). Both methods require general anesthesia and take roughly 1 to 2 hours. Vaginal bleeding and soreness may occur afterward. The average hospital stay is two to three days, and recuperation might take up to six weeks. When the uterus is removed through the vaginal canal, there is less blood, a speedier recovery, and no visible scar.
Hysterectomy can now be performed via laparoscopic or robotic-assisted laparoscopic surgery, thanks to technological advancements.
Through tiny incisions near the navel, thin equipment, and a small video camera are inserted. A monitor receives an image of the interior of the abdomen from the camera. Surgeons hold the equipment in their hands and use them to cut and stitch tissue while gazing at the monitor.
Robotic-assisted laparoscopic surgery
Laparoscopy is performed as normal. The devices, however, are carried by robotic arms rather than surgeons. Hand controls are used by surgeons to manipulate the robot’s arms. A console displays a 3-dimensional, extremely detailed (high-definition) image of the interior captured by the camera. Surgeons watch this image at a console and utilize a computer to transform their hand movements into accurate instrument movements. The hospital stay is only one day after either laparoscopic procedure. Laparoscopic surgery results in less discomfort, fewer problems, and a faster return to normal activities for women than open surgery (which involves a larger incision).
A hysterectomy can be done to address prolapse of the uterus, endometriosis, or fibroids, in addition to certain gynecologic malignancies (if causing severe symptoms). It’s sometimes done as part of the treatment for colon, rectum, or bladder cancer.
Hysterectomy comes in a variety of forms. The type that is employed is determined by the disease that is being treated.
Subtotal (supracervical) hysterectomy
The cervix is not removed, only the top section of the uterus. The ovaries and fallopian tubes may or may not be removed.
The whole uterus is removed, including the cervix.
The entire uterus is removed, together with the surrounding tissues (including the upper part of the vagina, ligaments, and, in most cases, lymph nodes). In women over 45, both the fallopian tubes and the ovaries are routinely removed.
Total hysterectomy is frequently performed for endometrial cancer or fallopian tube cancer. Treatment for cervical or vaginal cancer may entail a radical hysterectomy.
Menstruation stops after a hysterectomy. A hysterectomy, on the other hand, does not trigger menopause unless the ovaries are also removed. Hormone therapy may be advised if the ovaries are removed, as this has the same consequences as menopause.
After a hysterectomy, many women expect to be melancholy or lose interest in sex. However, unless the ovaries are also removed, hysterectomy rarely produces severe side effects.
Hormones such as estrogen, progestin, or both can be used to alleviate menopausal symptoms such as hot flashes and vaginal dryness after the uterus is removed. This treatment is risk-free and does not raise the risk of cancer recurrence.
Dissection of sentinel lymph nodes
The first lymph node to which cancer cells are anticipated to disseminate is called a sentinel lymph node. There could be many sentinel lymph nodes. These lymph nodes are known as sentinel lymph nodes because they are the first to detect the spread of malignancy.
- A sentinel lymph node dissection is the removal of one or more lymph nodes.
- The sentinel lymph node must be identified (called mapping)
- Getting rid of it
- Examining it to see if there are any cancer cells present
Doctors inject a blue or green dye and/or a radioactive material into the cervix to identify sentinel lymph nodes. These chemicals move to lymph nodes near the uterus and map the passage from the uterus to the next lymph node. Doctors check for lymph nodes that are blue or green in color or emit a radioactive signal during surgery (detected by a handheld device). Doctors remove this node (or nodes) and send them to a lab for cancer testing. No other lymph nodes are removed if the sentinel lymph node or nodes do not contain cancer cells (unless they look abnormal).
Instead of removing all lymph nodes, clinicians may perform sentinel lymph node mapping and dissection when cancer appears to be restricted to the uterus.