Minimally Invasive Hysterectomy

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 446,000 surgeries per year are still being performed using a traditional "open" approach.

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.

Minimally Invasive Hysterectomy Procedures

Vaginal hysterectomy - 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.

Two types of laparoscopic hysterectomies - 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.

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.

WHAT IS THE FUNCTION OF THE UTERUS?

The uterus is necessary to allow for the growth of a pregnancy. It is, in essence, the chamber in which the pregnancy grows. The uterus does NOT make eggs and does NOT make hormones.

WHAT IS THE FUNCTION OF THE OVARIES?

The ovaries produce eggs and release the hormones estrogen and progesterone. During the first half of a woman's monthly menstrual cycle, estrogen prepares the lining of the uterus for pregnancy. Midway through the cycle, the egg is released from the ovary. The ovary then starts to produce progesterone, which matures the lining of the uterus for implantation.

If intercourse occurs, and the sperm meets the egg to form the embryo, the embryo travels down the tube and implants into the matured uterine lining. If this occurs, the pregnancy develops and a menstrual cycle will NOT occur.

If intercourse does NOT occur, the sperm does not meet the egg, an embryo does not develop, there is no implantation of the embryo into the lining, and menstruation occurs (a period).

As you can see from these events, the ovary is responsible for all hormone production. At menopause, the ovaries stop producing eggs and stop producing hormones. The symptoms of loss of hormones, or menopause, include hot flashes, night sweats, mood sweats, anxiety, depression, vaginal dryness, and development of osteoporosis, all of which are due to lack of estrogen.