Hysterectomy Surgery

A hysterectomy is a surgery to remove the uterus, which is the female reproductive organ where a baby grows. The cervix, the lower part of the uterus that connects to the vagina, may also be removed during a hysterectomy. After a hysterectomy, you can't get pregnant and you won't have menstrual periods. 

It is a major operation that is usually performed to treat a medical condition, such as:

• Uterine fibroids: These are noncancerous growths that can cause heavy bleeding, pain, and pressure.

• Endometriosis: This is a condition in which tissue similar to the lining of the uterus grows in other parts of the body, such as the ovaries, fallopian tubes, and bladder.

• Uterine prolapse: This is a condition in which the uterus slips down into the vagina.

• Cancer of the uterus, cervix, ovaries, or fallopian tubes

There are many types of hysterectomy surgery, including: 

• Partial/subtotal hysterectomy: Also called a supracervical hysterectomy, this removes only the uterus.

• Total hysterectomy: This is the most common type of hysterectomy. It removes the entire uterus, cervix, and sometimes the ovaries and fallopian tubes.

• Radical hysterectomy: This removes the uterus, cervix, and upper part of the vagina. It's usually used for cancer treatment.

• Supracervical hysterectomy: This removes the upper part of the uterus, but leaves the cervix and lower part of the uterus in place.

Other types of hysterectomy surgery include: 

• Abdominal hysterectomy

• Vaginal hysterectomy

• Laparoscopic-assisted vaginal hysterectomy (LAVH)

• Total laparoscopic hysterectomy (TLH)

Different Methods of Hysterectomy

A hysterectomy can be performed vaginally, laparoscopically, or abdominally.

• Vaginal hysterectomy: This is the least invasive type of hysterectomy. It is performed through an incision in the vagina.

• Laparoscopic hysterectomy: This is a minimally invasive type of hysterectomy. It is performed through several small incisions in the abdomen. A laparoscope, a thin, lighted tube with a camera, is inserted into the abdomen to guide the surgeon.

• Abdominal hysterectomy: This is the most invasive type of hysterectomy. It is performed through a larger incision in the abdomen.

The specific steps involved in a hysterectomy procedure depend on the type of hysterectomy performed (subtotal, total, radical, or supracervical) and the patient's circumstances. However, the general procedure typically follows these steps:

1. Pre-operative Preparation:

   
   a. Medical Evaluation: The patient undergoes a thorough medical evaluation to assess their overall health and fitness for surgery. This includes a physical examination, medical history review, and necessary laboratory tests.
   b. Anesthesia: The type of anesthesia used depends on the patient's preference and the surgeon's recommendation. Options include general anesthesia, which induces unconsciousness, or regional anesthesia, which numbs the lower body.
   c. Catheter Placement: A urinary catheter is inserted to drain urine throughout the procedure and during recovery.

2. Surgical Procedure:

   
   a. Incision: The surgeon makes an incision in the abdomen or vagina, depending on the type of hysterectomy. For vaginal hysterectomy, the incision is made in the upper part of the vagina. For laparoscopic hysterectomy, several small incisions are made in the abdomen to insert laparoscopic instruments. For abdominal hysterectomy, a larger incision is made in the lower abdomen.
   b. Dissection and Ligation: The surgeon carefully separates the uterus from surrounding tissues, including the ovaries, fallopian tubes, and supporting ligaments. Blood vessels are ligated (tied off) to prevent bleeding.
   c. Uterus Removal: The uterus is removed through the incision. For subtotal hysterectomy, only the uterus is removed, and the cervix is left in place. For total hysterectomy, both the uterus and cervix are removed. For radical hysterectomy, the ovaries, fallopian tubes, and some lymph nodes may also be removed.
   d. Cervical Closure: If the cervix has been removed, the remaining vaginal cuff is closed using sutures.
   e. Wound Closure: The incision is closed using sutures, staples, or skin glue.

3. Post-operative Care:

   
   a. Recovery Room: The patient is transferred to the recovery room for monitoring of vital signs, pain management, and recovery from anesthesia.
   b. Hospitalization: The length of hospital stay depends on the type of hysterectomy and the patient's recovery. Most patients can go home within 2-3 days for a vaginal hysterectomy, 3-5 days for a laparoscopic hysterectomy, or 5-7 days for an abdominal hysterectomy.
   c. Pain Management: Pain medication is administered to manage postoperative discomfort.
   d. Activity Restrictions: Patients are advised to rest and avoid strenuous activities for several weeks to allow for proper healing.

   e. Follow-up Appointments: Regular follow-up appointments are scheduled with the surgeon to monitor healing and address any concerns.

Hysterectomy is a major surgery that removes the uterus, or womb. It is a common procedure, with over 600,000 performed each year in the United States. However, like any major surgery, there are some risks associated with hysterectomy.

Short-term risks

• Vaginal Bleeding

• Infection

• Blood clots under the sutures/haematoma

• Urinary tract infections (UTIs)

• Wound healing problems

• Pelvic pain

• Sexual dysfunction

• Internal scar tissue in the abdomen

Long-term risks

• Early menopause

• Osteoporosis

• Prolapse of other pelvic organs

• Bladder or bowel damage

• Ovary failure

Benefits of Hysterectomy Surgery

Here are some of the potential benefits of a hysterectomy:

• Control of menstrual bleeding

• Reduction of pain

• Treatment of fibroids

• Management of endometriosis

• Prevention of cancer

• Improved quality of life

General Guidelines for Recovery:

• Rest and avoid strenuous activity for several weeks after surgery.
• Pain medication can be prescribed to manage discomfort and cramping.
• Maintain a healthy diet and drink plenty of fluids to aid in healing.
• Avoid lifting heavy objects or engaging in activities that strain the abdomen or pelvic area.
• Avoid sexual activity for several weeks or until your doctor advises it is safe.
• Attend scheduled follow-up appointments with your surgeon to monitor healing and address any concerns.

The cost of a hysterectomy in Delhi can vary depending on several factors, including the type of hysterectomy, the surgeon's experience, and the hospital or clinic where the procedure is performed. However, in general, you can expect to pay between INR 40,000 and INR 75,000 for a hysterectomy in Delhi.