Understanding the Routes of Hysterectomy
When you and your gynecologist have decided on hysterectomy as the treatment of choice for your gynecologic diagnosis, there are several routes by which a hysterectomy may be accomplished. A total hysterectomy is the surgical removal of the uterus, and when indicated, the additional removal of the fallopian tubes and ovaries (termed salpingoophorectomy) may be recommended.
There are several routes by which a hysterectomy can be performed. You and your gynecologist will decide on the safest route for your hysterectomy based upon the reasons and clinical circumstances for the hysterectomy, your health history and the surgeon's clinical expertise.
The 4 main routes by which a hysterectomy is performed are abdominally, laparoscopically, Davinci assisted laparoscopically or vaginally. In an abdominal hysterectomy an abdominal skin incision (similar to a cesarean section incision) is made to accomplish the surgery. This route is especially advantageous when large uterine fibroids or significant abdominal adhesions are anticipated, allowing for more exposure to accomplish the surgery safely. Compared with the other minimally invasive routes, abdominal hysterectomy generally requires a longer hospital stay and longer recovery time.
Laparoscopic hysterectomy involves the use of a narrow camera (termed a laparoscope) and surgical instruments placed through small abdominal skin incisions to detach the uterus, which is then most commonly delivered through the vagina. This route may be selected when abdominal adhesions or a moderate-to-large sized uterus are suspected. The advantage with this minimally invasive approach is a shorter hospital stay and faster recovery time, when compared with abdominal hysterectomy. Your surgeon may offer Davinci hysterectomy, an advanced form of laparoscopic surgery, with proposed improved precision, visualization, and technical capabilities, for more complex procedures.
In the vaginal route (termed vaginal hysterectomy) the uterus is completely removed through the vagina, thereby avoiding any abdominal incisions. This route may be selected for a normal-to- moderately enlarged uterus, for pelvic organ prolapse, or when significant abdominal adhesions are not suspected. As with laparoscopic and Davinci hysterectomy, a shorter hospital stay and faster recovery are expected.
Though hysterectomies are the most common gynecologic surgery performed among women in the United States , any surgical procedure has inherent risks. Hysterectomy may be the best choice for your gynecologic condition. Be sure to consult with your physician in understanding the risks versus benefits…and your options.
So what should you expect in the first trimester of pregnancy? For many of you, this is a very exciting time. Especially if you’re a first time mom. There is A LOT happening in your body both hormonally and physically. Some will experience emotional swings because of the hormone surges. So husbands, please be understanding.
From a physical standpoint, it is not uncommon to feel menstrual type cramps because everything is growing and being stretched. This type of pain is typically cramping and sharp shooting in nature. This is because there are ligaments that are attached to your uterus. The easiest way to describe them is that they are like rubber bands that attach to your uterus. So as you grow, they stretch. And sometimes, if they stretch too much, they’ll spasm and you’ll experience a sudden sharp shooting pain. This pain can feel like someone is jabbing you from the vagina up (doesn’t that sound good), and sometimes it’ll feel like a shooting vaginal pain down wards or across your lower abdomin. These typically don’t last long, but it can be quite uncomfortable. This is completely normal. It does not mean you are trying to have a miscarriage. It’s normal growth. However, most Ob/Gyn’s will order an ultrasound to make sure everything is ok.
The other thing that can happen early on is nausea and vomiting. This is normal because of the hormonal changes that is occurring. It typically peaks between 8-10 weeks for most women, but some will continue beyond the 12th week. There are a wide range of treatment including vitamins, pressure point stimulator, and medicine that can help. Please talk to your health care provider if your experiencing severe nausea or vomiting.
The first trimester can also be a time of anxiousness. This is true for anyone that has had a miscarriage. Most miscarriage will happen in the first trimester, and the majority of these are related to chromosomal abnormalities. While there are certain behavors that may increase the risk of miscarriage such as smoking and high caffeine intake, the majority of miscarriages are uncontrollable. Symptoms of miscarrage are usually severe recurrent cramping that doesn’t ease up and vaginal bleeding. If you have these symptoms, please notify your health care provider.
Hope this quick synopsis helped answer some of your questions. Good luck!