What Is an Ovarian Cancer Hysterectomy?

Subtotal hysterectomy can be used to treat normal cervical examination. Patients also require cervical uterine fibroids, uterine functional bleeding, adenomyomas, or those who need to remove the uterus for various reasons, but have difficulty removing the cervix. Hysterectomy now has open, vaginal, and laparoscopic procedures, the latter two of which are minimally invasive.

Hysterectomy

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Causes of Hysterectomy

There are several reasons to remove the uterus, including:

(1) Severe chronic infection (pelvic infection STD)

(2) Severe endometrial infection

(3) Uterine fibroids

(4) Uterine fibroma, endometrial cancer

(5) Cervical cancer and ovarian cancer

(6) Severe uterine bleeding (uterine rupture, major postpartum hemorrhage)

Hysterectomy is a common gynecological operation. Surgery can be divided into total hysterectomy, partial hysterectomy and enlarged hysterectomy. Partial hysterectomy removes only the upper part of the uterus, leaving the base of the uterus and the cervix intact. Hysterectomy is the removal of both the uterus and the cervix. Enlarged hysterectomy removes the uterus, bilateral fallopian tubes and ovaries, and the upper tissues of the vagina. Hysterectomy can be performed through the abdomen or vagina. The former is called transabdominal hysterectomy and the latter is called transvaginal hysterectomy.

Due to the structural characteristics of the female reproductive tract, there are several methods that can be used to remove the diseased uterus. The traditional surgical method is to abdomen or transvaginally remove the uterus. Laparoscopic total hysterectomy means that the ligaments, blood vessels, and vaginal walls around the uterus are cut through the laparoscope, and the hysterectomy is removed from the vagina, and then the vaginal ends are sutured again under the laparoscope. In addition to total hysterectomy, laparoscopic hysterectomy has several different methods, including laparoscopic assisted vaginal hysterectomy (LAVH), laparoscopic subtotal hysterectomy, and laparoscopic intrafascial hysterectomy. Surgery.

Laparoscopic technology has brought medicine into the era of minimally invasive surgery. This era of minimally invasive surgery can be reduced to a few words, that is, minimal damage, minimal inflammatory response and optimal incision healing, minimal tissue scars, and optimal treatment effect.

Advantages of Hysterectomy

Laparoscopic hysterectomy started in 1989. With the development of various surgical instruments, this procedure has been widely carried out. Although LAVH is relatively easy to perform under laparoscopy, for some difficult cases, such as endometriosis and pelvic adhesions, it is difficult to pull down the uterus, and LAVH's vaginal surgery is very difficult. For such patients, laparoscopic hysterectomy is relatively easy because it is performed entirely laparoscopically. Compared with laparoscopic hysterectomy and vaginal hysterectomy, the vision of laparoscopic surgery is clearer. For patients with endometriosis and pelvic adhesions, laparoscopic hysterectomy avoids the difficulty of vaginal surgery. It also avoids the trauma of laparotomy and expands the scope of minimally invasive surgery, which is more advantageous.

In addition to laparoscopic total hysterectomy, laparoscopic surgery for other diseases can also be performed, such as endometriosis lesion removal, ovarian tumor resection, vaginal stump suspension, laparoscopic pelvic floor defect repair, bladder Cervical pubic comb ligament suspension and so on. At the same time, laparoscopic lymph node dissection can also be performed to treat endometrial cancer and cervical cancer.

Compared with open abdominal hysterectomy, because of its small incision and lower postoperative comorbidities, there is less opportunity for postoperative analgesia, and normal work and life can be restored faster. The feature of small laparoscopic incision is more beneficial to obese patients, and the visual field is clear during operation, avoiding the problem of poor healing caused by large abdominal incision.

Hysterectomy Selection Principles

Laparoscopy, vaginal and open hysterectomy, the former two have the characteristics of minimally invasive, they are much faster than open hysterectomy, and the postoperative recovery is in laparoscopic surgery and vaginal surgery There is no difference. Nevertheless, laparoscopic total hysterectomy still has incomparable advantages of vaginal hysterectomy, mainly because the pelvic situation can be clearly understood, the operative field is clear, and the lesions existing in the pelvic cavity can be processed at the same time. For complex cases, laparoscopic surgery is much safer than vaginal surgery. Therefore, for simple total hysterectomy, vaginal surgery or laparoscopic surgery can be used as the first choice. For pelvic adhesions, endometriosis and other lesions and laparoscopic hysterectomy should be the first choice. However, laparoscopy and vaginal hysterectomy still have their limitations, that is, they cannot complete hysterectomy for those with huge uterus or severe pelvic adhesions. For these patients, it should be fully estimated that open surgery should be selected before surgery. , Or encountered difficulties during the operation and switched to open abdomen.