Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Chapter 97 Abdominal hysterectomy
- Chapter 98 Vaginal hysterectomy
- Chapter 99 Uterine curettage
- Chapter 100 Radical hysterectomy
- Chapter 101 Vulvectomy
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 97 - Abdominal hysterectomy
from Section 21 - Gynecologic Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Chapter 97 Abdominal hysterectomy
- Chapter 98 Vaginal hysterectomy
- Chapter 99 Uterine curettage
- Chapter 100 Radical hysterectomy
- Chapter 101 Vulvectomy
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
Hysterectomy is the most common major gynecologic operation and the second most common major surgical procedure in the USA. More than half a million women undergo hysterectomy each year. It is estimated that by age 65, one third of women will have had their uteri surgically removed. In recent years, alternatives for treating gynecologic disease have decreased the number of hysterectomies performed. Improved systemic hormonal therapies, progestational intrauterine devices, and endometrial ablation techniques have effectively managed menorrhagia without removal of the uterus. Leiomyomas can now be treated with transcervical hysteroscopic resection or uterine artery embolization. In addition, minimally invasive surgery using laparoscopic and laparoscopic-robotic techniques are becoming increasingly common, replacing the traditional abdominal hysterectomy.
Simple total abdominal hysterectomy involves the removal of the uterine corpus and cervix through an abdominal incision. It is performed for a variety of indications including uterine leiomyomas, recurrent dysfunctional uterine bleeding, adenomyosis, chronic pelvic pain, pelvic abscesses, and pelvic organ prolapse. In addition, simple abdominal hysterectomy is performed for three malignant indications: adenocarcinoma of the endometrium, ovarian cancer, and early microinvasive cervical cancer. Preoperative bowel preparation facilitates exposure and reduces trauma to the bowel caused by retraction and packing. Transfusion for simple abdominal hysterectomy is rare, and the operative time is 1 to 2 hours. General anesthesia is usually chosen, although spinal anesthesia can be used.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 651 - 653Publisher: Cambridge University PressPrint publication year: 2013