Uterus Removal Surgery (Hysterectomy) in Delhi, India

Uterus removal surgery (Hysterectomy) is performed to treat severe conditions like gynecologic cancer, fibroids, chronic pain, and more.

Here are some of the conditions that may require uterus removal surgery:

1. Fibroids

2. Adenomyosis

3. Endometriosis

4. Abnormal uterine bleeding not controlled by medicines

5. Pelvic inflammatory disease

6. Uterine prolapse

7. Ovarian or uterine cancer

1. Patients with previous abdominal surgery/infection have higher chances of adhesions

2. Uncontrolled Diabetes

3. Hypertension

4. Thyroid disorder

5. Medical disorders like Heart disease and Chronic kidney disease etc.

6. Obesity

7. Anaemia

8. Patient on blood thinners

Preparation for uterus removal surgery is similar to any other major surgery. The doctor will discuss the surgical procedure in detail and explain its benefits and risks. If there are any medical conditions, ensure they are well-controlled before the surgery.

The doctor may also prescribe specific tests like cervical cytology, endometrial biopsy or pelvic ultrasound to confirm the medical condition. ECG, Chest X-Ray and some blood tests are done to check fitness for Anaesthesia.

Apart from this, other preparations for abdominal surgery may require:

• Pre Anaesthetic checkup (PAC)

• Stop taking blood-thinning medications for 5-7 days before the surgery

• Not to eat or drink anything at least 6-8 hours before the surgery

• Follow the doctor’s instructions for bowel preparation

• Avoid wearing jewellery to the hospital

• Keep all your documents and reports well organised

• Arrange for help at home because post-surgery, your doctor will be restricting some of your activities

Uterus removal surgery is done after inpatient hospitalisation, meaning that one needs to stay in the hospital for two to three days. The surgery begins by administrating general/regional anaesthesia. The surgery generally lasts one to three hours.

Depending on the conditions and symptoms, your doctor may perform the following types of uterus removal surgery:

1. Total Hysterectomy

This is one of the most common types of uterus removal surgery. In this procedure, the surgeon removes the entire uterus and the cervix (neck of the womb) with or without removing tubes and ovaries.

2. Partial Hysterectomy

During a partial hysterectomy, the surgeon removes only a portion of the uterus and may leave the cervix intact. This is not routinely performed.

3. Radical Hysterectomy

In this type of uterus removal surgery, the doctor removes the womb and the surrounding tissues and organs, including the ovaries, fallopian tubes, parametrium, lymph glands, fatty tissues, and part of the vagina. This is usually performed in cancer patients.

During surgery, your doctor may also remove your fallopian tubes and ovaries (salpingo-oophorectomy). This leads to surgical menopause. Discuss with your doctor ahead of time if you need this.

There are several different surgical approaches to performing a Uterus Removal Surgery (Hysterectomy). These include:

1. Vaginal Hysterectomy

During this surgical approach, the surgeon removes the uterus vaginally and sutures back the incision to aid healing. This procedure generally doesn’t leave any external cuts, meaning there won’t be any visible scars.

2. Laparoscopic Hysterectomy

During a laparoscopic hysterectomy, the surgeon makes small incisions in the abdomen and inserts a laparoscope, a long, thin tube with a light and camera attached at the top. Surgery is completed through special instruments using these small cuts (usually 3-5 mm ).

3. Robotic Hysterectomy

Da Vinci Robot is used during surgery by experienced surgeons. Robotic surgery being more precise helps in delicate and complex procedures that may be difficult or impossible with other methods. Often, robotic hysterectomy surgery makes minimally invasive surgery possible.

4. Abdominal Hysterectomy

A horizontal bikini-line incision, which lies about an inch above your pubic bone or vertical incision, may be given on the abdomen depending on the reason for surgery and the condition of the patient. The surgeon then removes the uterus and stitches the incision.

Selecting the correct approach to surgery plays a vital role in the success of the surgery and minimising the complications. Treatment has to be tailored as per the clinical profile of the patient.

Like any other major surgery, there are some risks associated with uterus removal surgery, including bleeding, infection, and reaction to anaesthesia.

Other complications may include:

• Blood clots in the legs may travel to other body parts.

• Damage to urinary bladder, ureter, bowel or other abdominal structures that may require further repair.

Once the uterus removal surgery is over, patients may need to stay in the hospital for one or two days. The stay may be extended if the patient has a post-operative fever, paralytic ileus or other concerns. The total recovery from uterus removal surgery usually takes six to eight weeks. Robotic and Laparoscopic surgeries usually have lesser bleeding, less post-op pain and discomfort, and faster return to normal activities.

After the surgery, one may feel soreness, itching, and pain at the incision site for a few days. The doctor will usually remove the drainage tube from the bladder within 48 hours of the surgery. The patient will be encouraged to get out of bed and take short walks as soon as possible. The doctor will ask to come back on the seventh to tenth day after discharge for the dressing change and monitor progress.

Apart from this, post-operative care includes:

• Stay physically active as advised by the physiotherapist

• Avoid indulging in strenuous physical activities, bending for at least 8-10 weeks

• No sexual intercourse for at least 8-10 weeks after the surgery

• Avoid prolonged cough and constipation

• Keep the incision area clean and dry

• Take vitamin supplements

• Maintain a healthy lifestyle

• Take a lot of water, fruits, and high fibre diet (as advised by the dietician)

• Follow your doctor’s recommendations regarding resuming normal activities

Reviewed by Dr. Ankita Singh, Senior Consultant, Obstetrics And Gynaecology on 21-June-2022

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