STEC 1070 Surgical Procedures 1 Module 5
September 4, 2013
Women are faced with many difficult decisions in life, but the decision on whether or not to have a hysterectomy can be the most difficult one she will ever make. It can threaten her character, sexuality, and fertility and could lead to lingering feelings of grief, depression, and loss. However, having a hysterectomy may be required to decrease pain, increase quality of life or preserve the patients life.
A hysterectomy as defined by Webster’s New World Medical Dictionary is a surgical operation that removes a woman’s uterus. [ (Merriam- Webster) ] The uterus is the organ designed to nourish a developing baby. ...view middle of the document...
Although the vast majority are benign, meaning they do not cause or turn into cancer, uterine fibroids can cause medical problems. Indications for hysterectomy in cases of uterine fibroids are excessive size (usually greater than the size of an eight month pregnancy), pressure or pain, and/or bleeding severe enough to produce anemia. [ (Edward L. Trimble) ] Many women with fibroids have only minor symptoms and do not need treatment. When symptoms cause severe pain fibroids can be treated with medications or can be removed with procedures such as a myomectomy; in this procedure, the fibroids are removed while leaving the uterus intact. However, the tumors may return.
Other reasons a hysterectomy is needed include endometriosis, prolapse of the uterus, abnormal vaginal bleeding, cervical dysplasia, adenomyosis, and cancer of the uterus, cervix, ovary, or endometrium. Approximately 10 percent of hysterectomies are performed to treat cancer—either cervical, ovarian, or endometrial. [ (Johns Hopkins Medicine) ] Ovarian cancer is often accompanied by symptoms attributable to other disease processes. It is the leading cause of death from gynecologic malignancies. [ (Alexander's Surgical Procedures) ] In the case of cancer, a hysterectomy would be performed utilizing the abdominal approach. An abdominal hysterectomy is most commonly used when the ovaries and fallopian tubes are being removed, when the uterus is enlarged, or when disease has spread to the pelvic cavity, as in endometriosis or cancer. The uterus is removed through the abdomen via a surgical incision(midline incision) about six to eight inches long, or a horizontal (transverse Pfannenstiel) incision, along the top of the pubic hairline is used.
The type of hysterectomy you receive depends on your medical history and general state of health and on the extent of the cancer growth. Medical centers and surgeons may choose to do the type of surgery that they have more experience in. [ (Healthwise) ] Other approaches include,
* Vaginal-This is done through a cut in the vagina. The doctor will take your uterus out through this incision and close it with stitches.
* Laparoscopic- A laparoscope is an instrument with a thin, lighted tube and small camera that allows your doctor to examine your pelvic organs. Your doctor will make three to four small cuts in your abdomen and insert the laparoscope and other instruments. He or she will cut your uterus into smaller pieces and remove them through the incisions.
* Laparoscopically assisted vaginal hysterectomy (LAVH)- Your doctor will remove your uterus through the vagina. The laparoscope is used to guide the procedure.
* Robotic-assisted- doctor uses a distinctive machine (robot) to do the surgery through small cuts in your belly, much like a laparoscopic hysterectomy [ (Edward L. Trimble) ]
Once the doctor has chosen the right technique for his patient, the surgery will be performed. As with the different approaches of...