We have changed our visitation policy for the safety of our patients and staff. Click here for the updated visitation policy and click here for information about COVID-19.

Lahey Health is now part of Beth Israel Lahey Health

(Surgical Removal of the Uterus; Abdominal Hysterectomy)

Click here to view an animated version of this procedure.

Definition

Hysterectomy is a surgery to remove the uterus. There are different types of surgeries, such as:

  • Supracervical hysterectomy—removal of the uterus without including the cervix
  • Total hysterectomy—removal of the uterus and cervix (the lower portion of the uterus leading to the vagina)
  • Radical hysterectomy—removal of the uterus, ovaries, fallopian tubes, upper part of the vagina, and the pelvic lymph nodes
  • Salpingo-oophorectomy—removal of the ovaries and fallopian tubes (may be combined with any of the above procedures)

Laparoscopic surgery uses small incisions to access the area. It can lead to fewer problems and shorter recovery than open surgery. Scars from the surgery will also be much smaller.

Reasons for Procedure

A hysterectomy may be done if there are health problems that cannot be treated by other means. Some common reasons are:

Surgery is often the last choice. Other treatments are often tried first.

Possible Complications

Complications are not common but all procedures have some risks. The doctor will review a list of possible problems from this surgery including:

Some things may increase the risk of problems such as:

  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity
  • Previous pelvic surgery or serious infection
  • Use of certain medicine

What to Expect

Prior to Procedure

The doctor will review results from earlier tests. Before the procedure the doctor may ask:

  • About any current medicine. Some medicine may need to be stopped up to 1 week before the procedure.
  • That you arrange for a ride home and help at home.
  • That you do not eat or drink anything after midnight the night before.

Anesthesia

General anesthesia will be used. You will be asleep during the surgery.

Laparoscopic Surgery
Laparoscopic hysterectomy
Copyright © Nucleus Medical Media, Inc.

Description of the Procedure

Your care team may give antibiotics just before surgery.

Small cuts are made in the lower belly. Small tools and a tiny camera are passed through the incisions. The surgeon will be able to see inside the belly. The uterus can be removed through these openings. Additional options include:

  • Laparoscopic-assisted vaginal hysterectomy—After the steps above, tissue is removed through the vagina.
  • Robot-assisted hysterectomy—the surgery is done with robot arms. This helps the surgeon do very fine movements. It can help to reduce injury to nearby tissue.

Immediately After Procedure

IV fluids and medicine will be given in recovery.

How Long Will It Take?

1 to 3 hours—although it may take longer

Will It Hurt?

You will not have pain during the surgery because of the anesthesia. The lower belly and incision will be sore for a few weeks. Pain medicine and support can ease discomfort. It will ease over time.

Average Hospital Stay

You may go home on the same day or the next. A longer stay may be needed if there are problems.

Post-procedure Care

At the Hospital

You will be encouraged to walk. A catheter may be left in place to help pass urine.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home

Movement can be uncomfortable for a few weeks. Some activity will be limited.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, leakage, or any discharge from the incision sites
  • Nausea and/or vomiting
  • Lightheadedness
  • Cough, shortness of breath, or chest pain
  • Heavy bleeding
  • Pain that you cannot control with the medications you have been given
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Swelling, redness, or pain in your leg

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

The American Congress of Obstetricians and Gynecologists  http://www.acog.org 

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 

CANADIAN RESOURCES

Canadian Medical Association  http://www.cma.ca 

Health Canada  https://www.canada.ca/en/health-canada.html 

References

American College of Obstetricians and Gynecologists. Committee Opinion No 701: Choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2017 Jun;129(6):e155-e159.

Hysterectomy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120815T1040007858. Updated March 2015. Accessed March 19, 2020.

Hysterectomy. EBSCO DynaMed website. Available at:  https://www.dynamed.com/procedure/hysterectomy/ . Updated August 16, 2019. Accessed March 19, 2020.

Nesbitt-Hawes EM, et al. Laparoscopic subtotal hysterectomy: evidence and techniques. J Minim Invasive Gynecol. 2013 Jul-Aug;20(4):424.

Revision Information

  • Reviewer: EBSCO Medical Review Board Mary-Beth Seymour, RN
  • Review Date: 09/2019
  • Update Date: 09/16/2020