A total abdominal hysterectomy is a procedure that surgically removes a woman’s uterus and her cervix, whereas a subtotal or partial hysterectomy (also known as supracervical hysterectomy) removes the uterus leaving the cervix in place. The removal of the uterus is considered an extreme procedure and one that shouldn’t be undertaken without sufficient reason.
When total abdominal hysterectomy is indicated
Total hysterectomy is the most common type of surgery to remove the uterus and may be resorted to when other treatments have been tried and have failed.
Endometriosis or uterine fibroids
Endometriosis is a condition where the cells that comprise the lining of the uterus begin to grow in places other than the uterus. When medical treatments have been tried and failed, surgical methods to remove the endometrial implants may be used.
In some cases hysterectomy may be indicated, however even this is not a guarantee against the disease returning at a later date. Very large or troublesome uterine fibroids may also require this type of surgery at times.
If cancer of the uterus, or the ovaries or other organs of the reproductive tract is diagnosed total abdominal hysterectomy is almost always the best option.
Severe and persistent pelvic pain and other reasons
The surgery can also be used as a last resort when a woman suffers from severe and chronic pelvic pain that doesn’t respond to other treatments. If there is heavy and consistent bleeding from the uterus or if a woman has uterine prolapsed, this surgery could be considered after exhausting other treatment options.
This type of hysterectomy can treat several persistent conditions and also facilitates a proper examination of the abdominal cavity by the surgeon. This can be vitally important for women with cancer since it can help to detect any additional tumors or metastases that have occurred where the cancer has spread to other organs and locations in the abdominal cavity.
Types of total abdominal hysterectomy
This surgery can be performed using one of several different methods.
With this technique, a large abdominal incision is made. A transverse incision is usually made just above the pubic line in about the same place as a C section incision. This type of surgery is done when a woman has had babies and has a relatively large uterus that cannot be removed any other way. Also if the doctors need to examine the pelvic cavity more closely (such as in the case of cancer), this type of surgery offers the greatest amount of access to the internal organs.
This type of total abdominal hysterectomy is performed entirely through the vaginal canal and has obvious advantages in that it is likely to have fewer complications and quicker recovery times.
Hysterectomy can also be done laparoscopically or may be assisted by way of laparoscope. Here the uterus may be removed though the small laparoscopy incisions or may be assisted by a laparoscope where the instruments are inserted by way of small incisions and the uterus is removed vaginally. These methods however are not used for total abdominal hysterectomy but for supracervical or cervix sparing procedures.