Hysterectomy is one of the most common surgeries in the United States, and the second most performed surgery for women of reproductive age. And while experts now concur that a minimally invasive hysterectomy is the "procedure of choice" for most women, many of the 550,000 surgeries per year are still being performed using a traditional “open” approach.21
The most common “open” procedure is a total abdominal hysterectomy (TAH), in which a large incision is made across the abdomen to access and remove the uterus. This type of procedure can lead to a longer stay in the hospital and recovery period. In contrast, minimally invasive hysterectomy generally requires a shorter hospital stay of one to three days and also happens to be more cost-effective.39
Minimally Invasive Hysterectomy Procedures
An incision is made at the top of the vagina, through which the uterus, including the cervix, is separated from surrounding tissue and then taken out through the vagina. This small vaginal incision heals quickly and usually won’t leave an external scar. There is little discomfort since the abdominal muscles are not stretched during the procedure. It takes one to two hours and requires a hospital stay of about one to three days. The recovery will usually take about four weeks.
A laparoscopically-assisted vaginal hysterectomy (LAVH) is similar to a vaginal hysterectomy in that the uterus and cervix are removed. But with LAVH, a laparoscope (a miniature camera) is used through a small incision for a view of the uterus, which is detached by specialized laparoscopic surgical tools that are inserted through the other small incisions. Once detached, the uterus is then removed through the vagina. Hospital stays and recovery times are similar to vaginal hysterectomy. Watch this animation which provides an overview of a laparoscopically-assisted vaginal approach to a hysterectomy.
Video presenting practical examples of difficult cases in vaginal hysterectomy and how the main challenge in each case can be overcome using advanced surgical techniques and instrument innovations. (Dr. Roseanne Kho, Mayo Clinic Arizona)
With a laparoscopic supracervical hysterectomy, the surgeon uses laparoscopic tools, inserted through small ¾-inch incisions, to separate the uterus from the cervix. The uterus is then removed through one of the small abdominal incisions. In this surgery, the cervix remains, which means routine pap smears are necessary to detect for cervical cancer. The procedure usually takes one to two hours, and a hospital stay of one to three days is usually required. The recovery for this type of hysterectomy will usually take about four weeks. Watch this animation which provides an overview of a. laparoscopic approach to a hysterectomy.
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