History of Hysterectomy

In November 1843, Charles Clay performed the first hysterectomy in Manchester, England.
In 1989, Harry Reich described the first laparoscopic hysterectomy using bipolar dessication; later he demonstrated staples and finally sutures for laparoscopic hysterectomy.

It may be found on the bladder or the bowel and in some cases even in other parts of the body such as the lungs and spinal cord.

What is Hysterectomy?

Hysterectomy is the removal of the uterus (womb).

Types of Hysterectomy

Total Abdominal Hysterectomy
This occurs when the uterus and cervix (neck of the womb) are removed through an abdominal incision (cut) – a “bikini cut” or midline cut below the umbilicus (belly button).

Sub-Total Hysterectomy
This is when the uterus is removed and the cervix left behind.
Total Abdominal Hysterectomy and Salpingo oophorectomy
When the uterus, the cervix the fallopian tube(s) and ovary (ies) are removed via an open approach.

Laparoscopic Hysterectomy
This approach involves a key hole cut on the abdomen. There could be 3 small cuts about 1-2 cm each. The locations of the cut involve one below the belly button and the others close to the pubic region. The size of the uterus or type of disease affecting the uterus will play a major decision on undertaking this type of operation.

Laparoscopic Assisted Vaginal Hysterectomy
The uterus is freed to some degree from the pelvis via key-hole surgery (Laparoscopy) and the rest of the operation is completed from below (vagina).

In the laparoscopic approach the ovaries and tubes can be taken along with the womb and cervix or independently.

Vaginal Hysterectomy
This procedure involvesperforming the whole operation from the vagina. The operation is performed mostly for uterine prolapse. Often times difficult to remove the ovaries by this route if they are not visible at the time of vaginal hysterectomy

There are varying indications for the different approaches listed above. The preferred method of approach would be discussed and reasons for the decisions would be outlined during consultation.