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Total Abdominal Hysterectomy: What is it?

Abdominal hysterectomies involve making an incision in the abdomen, usually horizontally from hip bone to hip bone at the public hair line, or vertically from the navel to the pubis. Typically the incision is four to six inches in length. Most patients prefer the horizontal incision because the scar is less noticeable. Surgeons prefer the vertical incision, because it gives them a clearer field for the operation.

Abdominal hysterectomy simply means that the uterus is removed through the abdominal wall. It doesn't refer to exactly how many of the female reproductive organs are removed. In addition to the uterus, some hysterectomies involve removal of the ovaries, fallopian tubes and cervix. This type of hysterectomy is usually an abdominal procedure.

This procedure involves a fairly lengthy recovery period, six weeks or more. As with any surgery, complications can occur, most frequently from adverse reaction to the anesthesia or from post operative infections. The rate of complications from abdominal hysterectomy is higher than those for vaginal hysterectomy because the surgery is more invasive.

There are a number of reasons for an abdominal hysterectomy, the two most common being cancer and endometriosis. Other reasons may include scarring from previous surgery to remove fibroid tumors, excessive or large fibroid tumors, or severe abdominal pain with no apparent cause. This procedure is usually not performed on women under thirty five who have no children, since it renders the woman sterile. In younger women, this type of surgery is only done for life threatening conditions like cancer or uterine hemorrhage or rupture.

In recent years there has been a move to use less invasive surgical techniques like vaginal hysterectomy and laparoscopic hysterectomy. Less invasive techniques mean a shorter recovery period and less risk of complications from infection. The risk of adverse reaction to anesthesia remains the same, as all these procedures are usually performed with a general anesthesia. There is generally less blood loss during the less invasive procedures, meaning less likelihood of complications from transfusions.

An abdominal hysterectomy is most often used for uterine cancer or cervical cancer which has spread, or for ovarian cancer, and endometriosis. In endrometriosis, tissue from the lining of the uterus migrates to other areas of the abdomen. Surgeons will not only remove the uterus, but any uterine tissue that is found outside the uterus. Endometriosis is an extremely painful condition. Obviously, the reason for performing an abdominal hysterectomy for cancer is to confirm the cancer has not spread and to remove any suspicious tissue in the abdomen. The surgeon needs a clear surgical field for these reasons.

Before undergoing any hysterectomy, you should speak with your doctor about your options. If your doctor feels that an abdominal hysterectomy is necessary in your case, ask him for his reasons. Do not be concerned about the scar, be concerned about the reasons your doctor prefers this procedure for your treatment. The scar can be minimized or even revised if necessary, the reasons your doctor has for recommending this procedure can involve serious health problems. If you have any doubts, seek a second opinion.

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