Minimally Invasive (laparoscopic) Hysterectomy in India

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Minimally Invasive (laparoscopic) Hysterectomy
in India
A hysterectomy is a surgical procedure to remove
the uterus. Historically, hysterectomies have
been performed either by making an incision in
the abdomen (either a "bikini" incision or a
vertical incision between the belly button and
the pubic bone) or, if the uterus is not too
large, an incision in the top of the vagina-a
vaginal hysterectomy. When an incision is made in
the abdomen, not only the skin but many other
layers need to be cut and to heal. This produces
a significant amount of post-operative pain and
recovery time. It is actually the healing of the
skin and other layers beneath it that accounts
for most of the pain women experience after a
hysterectomy, not the actual removal of the
uterus.

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When is Hysterectomy done?
Certain types of reproductive system cancers
(uterine, cervical, ovarian, endometrium) or
tumors, including uterine fibroids that do not
respond to more conservative treatment
options. Severe and intractable endometriosis
(growth of the uterine lining outside the uterine
cavity) and/or adenomyosis (a form of
endometriosis, where the uterine lining has grown
into and sometimes through the uterine wall
musculature), after pharmaceutical or other
surgical options have been exhausted. Chronic
pelvic pain, after pharmaceutical or other
surgical options have been exhausted.
Postpartum to remove either a severe case of
placenta praevia (a placenta that has either
formed over or inside the birth canal) or
placenta percreta (a placenta that has grown into
and through the wall of the uterus to attach
itself to other organs), as well as a last resort
in case of excessive obstetrical haemorrhage.
Several forms of vaginal prolapse

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Why Hysterectomy Surgery?
Uterine Fibroids  Are the common, benign (non
cancerous) tumors that grow in the muscle of the
uterus. More hysterectomies are done because of
fibroids than any other problem of the uterus.
Endometriosis Is another benign condition
that affects the uterus. It is the second leading
reason for hysterectomies. It occurs when
endometrial tissue (the inside lining of the
uterus) begins to grow on the outside of the
uterus and on nearby organs. Uterine
prolapse  Is a benign condition in which the
uterus moves from its usual place down into the
vagina. Uterine prolapse is due to weak and
stretched pelvic ligaments and tissues, and can
lead to urinary problems, pelvic pressure or
difficulty with bowl movements. Cancer is
the reason for about 10 percent of all
hysterectomies. Endometrial cancer, uterine
sarcoma, cervical cancer, and cancer of the
ovaries or fallopian tubes often require
hysterectomy. Depending on the type and extent of
cancer, other kinds of treatment such as
radiation or hormonal therapy may be used as
well.

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Different Techniques used for
Hysterectomy
1.Abdominal Hysterectomy - is the oldest
techniques in which the uterus is accessed
through a horizontal or vertical incision of
5"-7" made in the lower part of the abdomen (just
above the pubic line). This procedure is
generally used for radical hysterectomy as the
entire reproductive complex can be viewed and
explored through this incision. Since this
procedure involves the cutting of abdominal
muscles, recovery after this surgery is slow to
allow healing of the muscles. It generally takes
6 months for complete recovery. 2. Vaginal
hysterectomyAn incision is made at the top of the
vagina, through which the uterus, including the
cervix, is separated from surrounding tissue and
then taken out through the vagina. This small
vaginal incision heals quickly and usually wont
leave an external scar. There is little
discomfort since the abdominal muscles are not
stretched during the procedure. It takes one to
two hours and requires a hospital stay of about
one to three days. The recovery will usually take
about four weeks.

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