Uterine Fibroids and Hysterectomy - Surgery

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A variation of the vaginal approach is called laparoscopic-assisted vaginal hysterectomy (LAVH). It uses several small abdominal incisions through which the surgeon severs the attachments to the uterus and, if needed, ovaries. In LAVH, the uterus (and ovaries) are then removed through the vaginal incision, as in the standard vaginal approach. In laparoscopic hysterectomy, they are removed in small pieces through the abdomen.

Recovery times for vaginal hysterectomy and LAVH are shorter than those for abdominal hysterectomy. However, hospital stays may be longer and costs are greater with LAVH than with standard vaginal hysterectomy. Some doctors question whether LAVH adds any significant benefits compared to the standard vaginal procedure.

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Robotic Hysterectomy. Robotic hysterectomy is like laparoscopic hysterectomy, but a special machine is used. This approach is most often used when a patient has cancer or is very overweight and vaginal surgery is not safe.

Complications

Minor complications after hysterectomy are very common. About half of women develop minor and treatable urinary tract infections. There is usually mild pain and light vaginal bleeding post operation. More serious complications are uncommon but can include infection and blood clots.

Postoperative Care

The patient should ask a family member or friend to help out for the first few days at home. The following are some of the precautions and tips for postoperative care:

• For 1 - 2 days after surgery, the patient is given medications to prevent nausea and painkillers to relieve pain at the incision site.
• As soon as the doctor recommends it, usually within a day of the operation, the patient should get up and walk in order to help prevent pneumonia, reduce the risk of blood-clot formation, and speed recovery.
• Walking and slow, deep breathing exercises may help to relieve gas pains, which can cause major distress for the first few days.
• Coughing can cause pain, which may be reduced by holding a pillow over a surgical abdominal wound or by crossing the legs after vaginal surgery.
• Patients are advised not to lift heavy objects, not to douche or take baths, and not to climb stairs or drive for several weeks.
• For the first few days after surgery, many women weep frequently and unexpectedly. These mood swings may be due to depression from the loss of reproductive capabilities and from abrupt changes in hormones, particularly if the ovaries have been removed.