HYSTERECTOMY (Uterus Removal Surgery)

Removal of uterus is possible through different techniques –
➾ Laparoscopic Hysterectomy
➾ Laparoscopic Assisted Vaginal Hysterectomy
➾ Vaginal Hysterectomy
➾ Abdominal Hysterectomy.
 Now is the era for Laparoscopic Hysterectomy and the prerequisites are hi-tech equipment, skill sets to operate, proper patient selection.

Pre-operative preparation for any advanced laparoscopic pelvic surgery includes good bowel preparation and in our hospital we ask our patients to be on a milk free liquid diet for 2 days prior to surgery to aid proper emptying of intestines.

General anesthesia and at times Epidural anesthesia (for pain relief) along with general anesthesia is preferred which again is case specific.

After Pneumoperitoneum has been created by insufflating carbon dioxide into the belly with a Verres needle, an optical port is placed either at umbilicus or in supraumbilical crease depending on the size of the uterus and its adnexal masses. Minimum of 3 to 4 accessory ports are placed for operative ease. In our setup, we use Harmonic energy source as well as bipolar energy source for separating uterus from its pelvic attachments and delivering it from the natural birth passage. Vaginal vault is sutured with intra-corporeal suturing technique.

Postoperative management includes propped up position with nasal oxygen support for 2 hrs and then start oral feeds gradually.

Patient is mobilized next day in the morning and on day 3 of surgery, patient is sent home.

 Advantages of laparoscopic surgery are:

➾ Minimal pain
➾ Minimal hospital stay
➾ No stitches
➾ Early recovery and back to routine at the earliest