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A hysterectomy is the surgical removal of the uterus.
When the ovaries and fallopian tubes are also removed, this is called a hysterectomy with salpingo-oophorectomy.
A hysterectomy is done to treat uterine cancer, uterine fibroids, endometriosis, uterine prolapse, and other gynecological conditions.
When you arrive at the hospital for your surgery, an intravenous line will be started.
If you are having an abdominal hysterectomy, your pubic and abdominal area may be shaved.
Hysterectomies may be done under general or regional anesthesia.
If you are receiving general anesthesia, you will be asleep for the duration of the procedure and a breathing tube will be temporarily inserted through your mouth and into your throat to help you breathe during the operation.
A catheter will be placed into your bladder to drain your urine during surgery.
A hysterectomy takes about one to three hours.
There are three main ways to perform this surgery: through the abdomen, through the vagina, or using a laparoscope to assist a vaginal approach.
For an abdominal hysterectomy, your surgeon will make an incision in your lower abdomen, pull back the muscles to expose the uterus, cut the ligaments and tissues holding the uterus in place, and remove the uterus through the abdominal incision.
If your procedure includes a salpingo-oophorectomy, your surgeon will remove the ovaries and fallopian tubes in the same manner.
For a vaginal hysterectomy, a weighted speculum is inserted into your vagina to stretch it and hold it open.
Your surgeon will make an internal incision around the cervix, cut the ligaments and tissues holding the uterus in place, and slide the uterus out through the vagina.
For laparoscopic-assisted vaginal hysterectomy, your surgeon will create several small incisions, called ports, in your abdomen.
Carbon dioxide gas is then pumped through one of the ports to puff up your abdomen so its contents can be viewed more easily.
Your surgeon will then insert a laparoscope through one of the ports.
Images from its camera are projected onto a video monitor in the operating room.
Watching on the monitor, your surgeon will slip specialized surgical tools through the other ports and use them to make an incision around the cervix, cut the uterus free from its supporting ligaments and tissues, and pass it out through the vagina.
A laparoscope can also be used for a salpingo-oophorectomy.
Finally, your surgeon will close the incisions on your abdomen with stitches.
In all three hysterectomy procedures, the top of the vagina is stitched closed and gauze packing is placed in the vagina to prevent excess bleeding.
After your surgery, you will be taken to the recovery area for monitoring.
The catheter and the gauze packing will be removed before you leave the hospital.