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Hysterectomies may be performed in advanced cases of cancer or if a woman has dysfunctional uterine bleeding, troublesome fibroids, or endometriosis. In the past, hysterectomy was a complicated procedure that required a hospital stay and lengthy recovery time. Newer hysterectomy methods make it possible to reduce the time a patient spends in the hospital and make the recovery period shorter. One form of this procedure is the laparoscopic supracervical hysterectomy.
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Cancer is the reason for approximately ten percent of hysterectomies. This procedure can be performed in cases of cervical, endometrial, uterine, and ovarian cancers as well as cases of colon and bladder cancer that have spread to the reproductive system. Fibroids are the most common reason for hysterectomies that are not performed due to the presence of cancer. If fibroids are causing anemia, uncontrolled bleeding, compression of the urinary tubes, and long-term abdominal pain and pressure, hysterectomy may be performed. This procedure may also be performed to treat the pain associated with endometriosis, uterine prolapse, or chronic pelvic pain.
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How the Procedure is Performed
Laparoscopic supracervical hysterectomy is performed while a patient is under general anesthesia. The doctor places a retractor through the vagina and into the cervix, which helps to position the uterus so that it can be properly visualized. Three small incisions are made during this procedure. One is made at the base of the belly button and the other two are made near the hipbones. Once these incisions have been made, the abdomen is filled with carbon dioxide gas so that the internal organs are protected when surgical instruments are inserted in the abdominal cavity.
The laparoscope is placed through the belly button incision and the instrument used for grasping and cutting is placed through one of the small incisions near the hip. The other hip incision is used for placement of the retractor. The uterus is released from the blood vessels and cervix and the doctor supports the cervix by placing sutures in the ligaments. Once this has been done, the cervical canal is coagulated to prevent bleeding on a monthly basis. The peritoneum is then placed over the cervix and a morcellator is inserted through the belly button incision. The uterus is removed in strips and the doctor checks for bleeding. If no bleeding has occurred, all instruments are removed from the abdomen and the carbon dioxide gas is emptied from the cavity. The incisions are then closed with stitches.
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Recovery and Follow Up
Total abdominal hysterectomies require a hospital stay of five to six days and a recovery time of six weeks. This less invasive procedure may be done on an outpatient basis or require a hospital stay of only one day. The recovery time is two to three weeks, which allows patients to get back to work much more quickly than other types of hysterectomies. Because the cervix is left intact, women who have this procedure will still need to have yearly Pap smears.