In November 1843, Charles Clay performed the first hysterectomy in Manchester, England.
In 1989, Harry Reich described the first laparoscopic hysterectomy using bipolar dessication; later he demonstrated staples and finally sutures for laparoscopic hysterectomy.
What is Hysterectomy?
Hysterectomy is the removal of the uterus (womb).
Types of Hysterectomy
Total Abdominal Hysterectomy This occurs when the uterus and cervix (neck of the womb) are removed through an abdominal incision (cut) – a “bikini cut” or midline cut below the umbilicus (belly button).
Sub-Total Hysterectomy This is when the uterus is removed and the cervix left behind.
Total Abdominal Hysterectomy and Salpingo oophorectomy When the uterus, the cervix the fallopian tube(s) and ovary (ies) are removed via an open approach.
Laparoscopic Hysterectomy This approach involves a key hole cut on the abdomen. There could be 3 small cuts about 1-2 cm each. The locations of the cut involve one below the belly button and the others close to the pubic region. The size of the uterus or type of disease affecting the uterus will play a major decision on undertaking this type of operation.
Laparoscopic Assisted Vaginal Hysterectomy The uterus is freed to some degree from the pelvis via key-hole surgery (Laparoscopy) and the rest of the operation is completed from below (vagina).
Salpingo-oophorectomy In the laparoscopic approach the ovaries and tubes can be taken along with the womb and cervix or independently.
Vaginal Hysterectomy This procedure involvesperforming the whole operation from the vagina. The operation is performed mostly for uterine prolapse. Often times difficult to remove the ovaries by this route if they are not visible at the time of vaginal hysterectomy
There are varying indications for the different approaches listed above. The preferred method of approach would be discussed and reasons for the decisions would be outlined during consultation.
Recovery from Surgery
The recovery period after Key-hole surgery is shorter and pain following the operation is less, however, the duration of operation and period under general anaesthesia is usually longer.
The recovery period following abdominal hysterectomy is usually longer and time back to normal activities is longer as well.