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Hysterectomy

From Surgopaedia

Indications:

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  • Fibroids 30%
  • Endometriosis 20%
  • Endometrial Ca
  • Cervical Ca

Techniques

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  • TVH +/- Lap assistance
    • Safest, quickest, cheapest, easiest option
    • Use this unless contraindications
    • Average 45min
  • Open abdominal
    • Average 55min
    • Longest recovery time
    • Allows combination with other operations
  • Lap abdo
    • Average 85 min


Subtotal - now no reason to do this. Not safer.


Important steps

  • Ligate Round ligament/fallopian tube
  • Ligate uterine artery/vein - careful to avoid ureter

Complications

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  • Injury to local structures, especially ureter
  • Can push into early menopause if ovaries tampered with
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