Hysterectomy PDF

Hysterectomy Dr. Ahmed Reda Lecturer in Obstetrics and Gynecology  Definition Hysterectomy is surgical removal of the uterus. Salpingectomy is surgical removal of the fallopian tube. Oophorectomy is surgical removal of the ovary. Indications Obstetrical...

Hysterectomy Dr. Ahmed Reda Lecturer in Obstetrics and Gynecology  Definition Hysterectomy is surgical removal of the uterus. Salpingectomy is surgical removal of the fallopian tube. Oophorectomy is surgical removal of the ovary. Indications Obstetrical Gynecological Rupture of the uterus. Abnormal uterine bleeding Uncontrollable post-partum Benign conditions (eg. myoma) hemorrhage. Malignancy (uterus, cervix, Placenta accreta. ovary) Uterine prolapse Types Total hysterectomy: – removing the body of the uterus and the cervix. Subtotal hysterectomy (partial): – removing the body of the uterus, but leaving the cervix in place. Total hysterectomy and bilateral salpingo-oophorectomy (Pan hysterectomy) – Total hysterectomy and bilateral removal of both ovaries and both tubes Radical hysterectomy (Wertheim) – is done specifically in the case of cancer. – Removal of the uterus, both tubes, both ovaries, the upper third of the vagina, the iliac and obtruator lymph gland.  Total hysterectomy Advantage: avoids the risk of cancer cervix. It is the RECOMMENDED procedure. Subtotal hysterectomy Advantages Easier Quicker Less complications Cervix act as a support for vagina  decrease prolapse Disadvantages Risk of cancer cervix.  Abdominal hysterectomy Removal of the uterus through abdominal incision The traditional route  Vaginal hysterectomy Removal of the uterus through the vagina Advantage: – No abdominal scar (better cosmotic) – Early and easier ambulation. – Less complications. Disadvantages: – More difficult – Not feasible in all cases Laparoscopic hysterectomy Advantages: Disadvantages: – Minimally invasive procedure – Technically more difficult  Better satisfaction – Special equipment  Less postoperative pain. – Cost  Early discharge. Robotic hysterectomy Complications Hemorrhage. Shock. Infection. Injury to nearby structures. Respiratory complications. Venous thrombosis (DVT). Post operative anesthetic complications e.g. Cyanosis, vomiting. Menopausal symptoms (in younger female). Any questions?? Thank you