Treatments

A hysterectomy is an operation to remove a woman's uterus. A woman may have a hysterectomy for different reasons, including: Uterine fibroids that cause pain, bleeding, or other problems Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal Cancer of the uterus, cervix, or ovaries Endometriosis Abnormal vaginal bleeding Chronic pelvic pain Adenomyosis, or a thickening of the uterus Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success. Types of Hysterectomy Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is important to clarify if the cervix and/or ovaries are removed: In a supracervial or subtotal hysterectomy, a surgeon removes only the upper part of the uterus, keeping the cervix in place. A total hysterectomy removes the whole uterus and cervix. In a radical hysterectomy, a surgeon removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina. Radical hysterectomy is generally only done when cancer is present. The ovaries may also be removed -- a procedure called oophorectomy -- or may be left in place. When the tubes are removed that procedure is called salpingectomy. So, when the entire uterus, both tubes, and both ovaries are removed, the entire procedure is called a hysterectomy and bilateral salpingectomy-oophorectomy. Surgical Techniques for Hysterectomy Surgeons use different approaches for hysterectomy, depending on the surgeon’s experience, the reason for the hysterectomy, and a woman's overall health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation. There are two approaches to surgery - a traditional or open surgery and surgery using a minimally invasive procedure or MIP. Open Surgery Hysterectomy An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy, accounting for about 54% for all benign disease. To perform an abdominal hysterectomy, a surgeon makes a 5- to 7-inch incision, either up-and-down or side-to-side, across the belly. The surgeon then removes the uterus through this incision. Following an abdominal hysterectomy, a woman will usually spend 2-3 days in the hospital. There is also, after healing, a visible scar at the location of the incision. Abdominal hysterectomy. Most women go home 2-3 days after this surgery, but complete recovery takes from six to eight weeks. During this time, you need to rest at home. You should not be doing housework until you talk with your doctor about restrictions. There should be no lifting for the first two weeks. Walking is encouraged, but not heavy lifting. After 6 weeks, you can get back to your regular activities, including having sex. Vaginal or laparoscopic assisted vaginal hysterectomy (LAVH). A vaginal hysterectomy is less surgically invasive than an abdominal procedure, and recovery can be as short as two weeks. Most women come home the same day or the next. Walking is encouraged, but not heavy lifting. You will need to abstain from sex for at least 6 weeks. Laparoscopic supracervical hysterectomy (LSH). This procedure is the least invasive and can have a recovery period as short as six days to two weeks. Walking is encouraged, but not heavy lifting.

You’ve had painful attacks caused by gallstones. To treat the problem, your doctor advised to remove your gallbladder? This surgery is called cholecystectomy. Removing the gallbladder can relieve pain. It will also prevent future attacks. You can live a healthy life without your gallbladder. You may also be able to go back to eating foods you enjoyed before your gallbladder problems started. There are 2 methods for removing the gallbladder. We will choose which method is best for you: Laparoscopic cholecystectomy. This is most common. During surgery, 2 to 4 small incisions are made. A thin tube with a camera is used. This is called a laparoscope. The scope is put through one of the incisions. It sends images to a video screen. Surgical tools are put through other incisions. The gallbladder is removed using the scope and these tools. Open cholecystectomy. One larger incision is made. The surgeon sees and works through this incision. Open surgery is most often used when scarring or other factors make it a better choice for you. In some cases, safety requires a change from laparoscopic to open surgery during the procedure.

Hernia repair surgery is the world’s most common surgical procedure. Hernia surgery can help to relieve pain, return the hernia abdominal organs to their correct place and, strengthen the weak muscle area. A hernia operation usually takes around an hour as a day case procedure. It can be performed by: • Open surgery – under local or general anaesthetic, an incision usually around 2.5 to 3 inches is made to your skin near your hernia and your surgeon will push your hernia back into your abdomen. The incision is then either stitched closed or much more commonly a mesh is placed over the hole and fixed using fine stitches. The mesh acts like a scaffold and your own tissue will grow through the mesh to reinforce the weakened area without putting tension on the surrounding tissues. • Keyhole (laparoscopic) surgery – under general anaesthetic, several smaller incisions are made to allow surgeon to use a less invasive technique using various special instruments including a tiny telescopic camera to repair your hernia. A mesh may then be used to strengthen your abdominal wall. If hernia surgery is recommended, we will advise on the most appropriate type of surgery based on the location and severity of your hernia.