Suzanne R Trupin, MD
Dr. Suzanne Trupin is a Clinical Professor of Obstetrics and Gynecology at the University Of Illinois College Of Medicine at Urbana-Champaign. She graduated from Stanford University and completed her medical training at New York Medical in Valhalla, New York. She received her residency training at the University of Southern California Women's Hospital in Los Angeles, California. She is Board-Certified by the American Board of Obstetrics and Gynecology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- What is a hysterectomy?
- How common is hysterectomy?
- Why is a hysterectomy performed?
- What tests or treatments are performed prior to a hysterectomy?
- How is a hysterectomy performed?
- What are the types of hysterectomies
- Total abdominal hysterectomy
- Vaginal hysterectomy
- Laparoscopy-assisted vaginal hysterectomy
- Supracervical hysterectomy
- Laparoscopic supra cervical hysterectomy
- Radical hysterectomy
- Oophorectomy and salpingo-oophorectomy (removal of the ovaries and/or Fallopian tubes)
- What are complications of a hysterectomy?
- What are the alternatives to a hysterectomy?
- Should women who have had a hysterectomy continue to have PAP smears?
- Find a local Obstetrician-Gynecologist in your town
Laparoscopy-assisted vaginal hysterectomy (LAVH)
Laparoscopy-assisted vaginal hysterectomy (LAVH) is similar to the vaginal hysterectomy procedure described above, but it adds the use of a laparoscope. A laparoscope is a very thin viewing tube with a magnifying glass-like device at the end of it. Certain women would be best served by having laparoscopy used during vaginal hysterectomy because it allows the upper abdomen to be carefully inspected during surgery. Examples of uses of the laparoscope would be for early endometrial cancer (to verify lack of spread of cancer), or if oophorectomy (removal of the ovaries) is planned. Compared to simple vaginal hysterectomy or abdominal hysterectomy, it is a more expensive procedure, is more prone to complications, requires longer to perform, and is associated with longer hospital stays. Just as with simple vaginal hysterectomy without a laparoscope, the uterus must not be excessively large. The physician will also review the medical situation to be sure there are no special risks prohibiting use of the procedure, such as prior surgery that could have increased the risk for abnormal scarring (adhesions). If a woman has such a history of prior surgery, or if she has a large pelvic mass, a regular abdominal hysterectomy is probably best.
A supracervical hysterectomy is used to remove the uterus while sparing the cervix, leaving it as a "stump." The cervix is the area that forms the very bottom of the uterus, and sits at the very end (top) of the vaginal canal (see illustration above). The procedure probably does not totally rule out the possibility of developing cancer in this remnant "stump." Women who have had abnormal Pap smears or cervical cancer clearly are not appropriate candidates for this procedure. Other women may be able to have the procedure if there is no reason to have the cervix removed. In some cases the cervix is actually better left in place, such as some cases of severe endometriosis. It is a simpler procedure and requires less time to perform. It may give some added support of the vagina, decreasing the risk for the development of protrusion of the vaginal contents through the vaginal opening (vaginal prolapse).
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