Laparoscopic Hyesterctomy Treatment in India at Aastha Healthcare Hospital

Uterus is a hollow, muscular, pear shaped organ often referred to as Womb since Biblical times. It has two tubes called fallopian tubes connected to it at one end and to the ovary at the other. When an egg cell is released from an Ovary it travels to the uterus via these fallopian tubes. It is a very remarkable organ capable of expanding to contain a full-grown baby and of shedding its lining up to 500 times during the life that is during the time of monthly period. The resultant stresses and strains on its supporting structures during pregnancies and the repeated shedding and re-growth of its lining may lead to problems.

What is hysterectomy?

Hysterectomy merely means surgical removal of uterus. It is the second most common major operation performed today. Hysterectomy involves removal of the uterus, and sometimes the ovaries too (oophorectomy). Often one or both ovaries and fallopian tubes are removed at the same time a hysterectomy is done.

Sub-total or partial hysterectomy
It involves the removal of Fallopian tubes and the upper two-thirds of the uterus only, preserving the cervix.

Hysterectomy with ovarian conservation
It involves the removal of the Fallopian tubes, uterus and the cervix, while preserving the ovaries.

Hysterectomy with oophorectomy
It involves the removal of the Fallopian tubes, uterus and cervix, together with one or both sets of ovaries.

Radical or Wertheim's hysterectomy
It involves the removal of the Fallopian tubes, uterus, cervix, ovaries as well as nearby lymph nodes and the upper portion of the vagina. This type of hysterectomy is used in the treatment of some gynaecological cancer cases.

Before having a hysterectomy, it is very important to discuss the implications you're your gynaecologist and partner. Your doctor may recommend a hysterectomy if none of the treatments for the various conditions have worked. Ofcourse in some cases, there is no other choice than hysterectomy.

Why should one go for hysterectomy?

Hysterectomy is used to treat :

Fibroids- This is the most common reason for which hysterectomies are done. For many women with fibroids, symptoms are minimal and require no treatment. Also, the fibroids often shrink after menopause. But in some cases, fibroids can cause heavy bleeding or pain in some women.

Endometriosis- This happens when the tissue lining the inside of your uterus grows outside the uterus on your ovaries, fallopian tubes, or other pelvic or abdominal organs. The surrounding tissue may become scarred, and often other organs such as the uterus, bladder or the rectum may become stuck down in these scars (adhesions). When medication and surgery do not cure endometriosis, a hysterectomy often is performed.

Uterine prolapse- This is when the uterus moves from its usual place down into the vagina. This can lead to urinary problems, pelvic pressure, or difficulty with bowel movements.

Cancer- Cancer of the uterus, cervix, or ovary, is another cause for hysterectomy.

Persistent vaginal bleeding- If menstrual flow is heavy, not regular, or last for many days and non-surgical methods have not helped to control bleeding, a hysterectomy may bring relief. But ofcourse the physician screens the candidate if she is suitable for the surgery.

Chronic pelvic pain- Surgery is a last resort for women who have chronic pelvic pain that clearly comes from the uterus.

Often a doctor will have a fairly good idea of the type of the problem after examining and listening to the patient's symptoms. The doctor will make detailed notes of medical history and the patient's concerns. The physician will then inform the patient about different types of hysterectomy procedures. It is important that women understand the full implications of the removal or certain reproductive organs so that they can be properly prepared for any resultant side effects.

Before the surgery

The doctor will once again examine the patient thoroughly. The blood will probably be tested for hormone levels and also a pelvic ultrasound scan may be recommended. If the scan shows any abnormalities or is unclear, the doctor may want to investigate further using hysteroscopy, a procedure in which a viewing device is inserted into the uterus. A sample of the lining of the womb (endometrium) may be taken. Endometrial sampling is done either as an outpatient procedure, or by D&C-dilatation and curettage, usually when under a general anaesthesia. In a D&C, the cervix is opened (dilatation) and the lining of uterus (the endometrium) will be systematically scraped (curettage) with a long, thin instrument. The strips of the lining will then be examined under a microscope.

Preparation for both vaginal and abdominal hysterectomy is similar. She will be given a suppository to empty the bowels the night before. She will be told not to eat or drink anything on the day of the surgery about 6 to 8 hours before the surgery. Anaesthesia is given. It can be general, epidural or spinal anaesthesia. A catheter (a narrow silicon tube) is inserted into the bladder to empty it. The operation area is cleaned thoroughly with antiseptic before the operation.

The surgery

The actual hysterectomy operation can be performed in several different ways. The method chosen will depend on the surgeon's skills, expertise and preference, the reason for the hysterectomy and the woman's characteristics (e.g. weight, previous pelvic surgery, if she has had children). There are presently following ways to perform a hysterectomy :

Abdominal hysterectomy

Vaginal hysterectomy

Laparoscopic method

After the surgery

The average hospital stay depends on the type of hysterectomy performed, but is usually from 2 to 3 days. Complete recovery may require 2 weeks to 2 months. Recovery from a vaginal or laparoscopic hysterectomy is faster than from an abdominal hysterectomy, and may include less pain. Removal of the ovaries along with the uterus in premenopausal women causes immediate menopause, and oestrogen replacement therapy may be recommended. Some patients report that the incisions feel a little sore and the residual gas in the belly hurts a bit. This gas often collects under the right diaphragm and causes the sensation of right shoulder pain.

Intravenous and oral medications are used after the surgery to relieve postoperative pain. A catheter may remain in place for 1 to 2 days to help the bladder pass urine. Moving about as soon as possible helps to avoid blood clots in the legs and other problems. Normal diet is encouraged as soon as possible after bowel function returns. The physician may advice to take some precautions like avoiding lifting heavy things etc. th epatient may also be recommended to take Hormone Replacement Therapy (HRT) which means replacing the missing female hormone oestrogen with tablets.

Benefits and drawbacks of laparoscopic hysterectomy

One advantage of laparoscopic hysterectomy is that the incisions are smaller (1/2 inch) and much less uncomfortable than that of abdominal hysterectomy. So people are able to resume normal activity in about 2 weeks. So Laparoscopic hysterectomy has many advantages like :

Less postoperative pain

May shorten hospital stay

May result in a quicker return to bowel function

Quicker return to normal activity

Better cosmetic results

However, the surgeon must be experienced in the procedure before these benefits can be seen or else complications may occur. Disadvantages include a possible longer operating time (depends on how much of the operation is performed laparoscopically), higher costs and an increased risk of damage to the urinary tract.

For more information on Laparoscopic Hyesterctomy Treatment, kindly visit :
http://www.aasthahealthcare.com/Laparoscopic-Hyesterctomy-Treatment.htm

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