DR. ANSHU AGARWAL

MBBS

MS (Obstertrics & Gynaecology)

Senior Consultant HEC PARAS HOSPITAL, Ranchi

Ex. Senior Resident Safdarjung Hospital, Delhi

Laparoscopy & InfertilitySpecialist

NDVH

Hysterectomy

Hysterectomy means removal of the uterus by surgery. Hysterectomy surgery also may remove cervix, ovaries, fallopian tubes and other surrounding structure, if needed.

When hysterectomy is suggested (indications) :-

If someone is suffering from chronic pelvic pain, Cancer of the ovaries, uterus or cervix,
Uncontrollable vaginal bleeding, Tumors or fibroids  growing in uterur, When uterus drops through the cervix and protrudes from the vagina. An infection in the reproductive system, pelvic inflammatory disease.

Some Types of Hysterectomy:-

Partial Hysterectomy:-

When cervix remain intact and a portion of the patient’s uterus is removed.

Total Hysterectomy:-

When entire uterus and cervix is removed.

Salpingo_Oophorectomy:-

During this process, Doctor removes uterus along with one or both of the patient’s ovaries and fallopian tubes. Hormone replacement therapy may be needed if both of the ovaries are removed.

Methods Of Hysterectomy:

Hysterectomy may be performed in different ways. General or local anaesthetic is used to perform the operation.

Abdominal Hysterectomy:-

During an abdominal hysterectomy, the uterus is removed through a large horizontal or vertical cut in the patient's abdomen.

Vaginal Hysterectomy:-

During the vaginal hysterectomy, the uterus is removed through the vagina by a small incision, it is done in cases of uterine prolapse that is protruding out of uterus through the vagina. No external visible scars.

Non descent vaginal hysterectomy:-

During NDVH, uterus is removed through the vagina. It is done in all cases as of abdominal hysterectomy except very big size uterus and except in cases of cancer uterus, cervix and ovaries.

Laparoscopic Hysterectomy:-

During this surgery, an instrument is used called a laparoscope, which is a long, thin tube with a high intensity light and a high resolution camera at the front part of the instrument. It is inserted through a very small incision in the abdomen. Some small
incisions are made to remove the uterus.

Is it a risky operation?

A hysterectomy is considered to be a fairly safe procedure. But some patients may have an adverse reaction to the anesthetic, heavy bleeding or an infection around the incision mark may happen. In some cases surrounding tissues or organs like bladder, intestine or blood vessels may be injured.  But the chances are rare and if they occur, it can be corrected in the same sitting.

Post hysterectomy care:-

After the hysterectomy, patients needs to spend three to five days in the hospital. During this period, doctors would give medicine for the pain and would monitor the patient’s heart rate and breathing.
Walking is necessary to prevent blood clots forming in the legs.
In case of vaginal hysterectomy, vagina will be packed with gauze to control the small oozing. After a few days, patients can use menstrual pads for about 10 days as patient may experience vaginal secretion.

Patient should avoid certain activities such as lifting heavy items, push or pull some objects and sexual intercourse.

The complete healing span of laparoscopic hysterectomy is about four to six weeks.

Some important facts should be known before hysterectomy. Once a patient had a hysterectomy, she will stop having menstrual periods.

She can’t be pregnant again . Hormonal therapy may be required.

Why it is better than an open resection?

Recovery rate is faster in laparoscopic surgery.


The patients also feel less pain and small scar.
Short hospital stay.
Only after one or two weeks, patients may get back in their normal routine life.
Doctors recommend eating low fiber diet for a month

But some complications may happen like any other surgery.
Some of the complications are:

  • Scar tissue infection
  • Internal bleeding
  • Blockage of the intestines
  • High Risk Obstetrics