There are three types of hysterectomy
Total Laparascopic Hysterectomy
Dr Polyakov has particular expertise in Total laparoscopic hysterectomy after having trained and worked in an advanced laparoscopic unit for many years.
What is total Laparascopic Hysterectomy?
Total laparoscopic hysterectomy is a surgical procedure for the removal of the uterus and cervix. In this technique, the uterus is separated from its attachments to the pelvis and removed through the vagina. The ovaries and fallopian tubes can also be removed. Dr Polyakov will discuss this with you
Why is a Laparascopic Hysterectomy Performed?
Total laparoscopic hysterectomy is done to treat conditions such as painful or heavy menstrual periods, pelvic pain, fibroids or may be performed as a part of cancer treatment. You should clearly understand the reason for this surgery.
What can be expected during the recovery period?
You will be in the recovery room when you wake up from anesthesia. You may feel sleepy for the next few hours. You may have pain in the shoulder or back which is because of the gas used in the procedure. It resolves within a day or two. You will start eating and drinking normally within a short period of time.
You may have some discomfort or feel tired for a few days after the procedure. Constipation is very common. You will be in hospital for two days following the procedure. Dr Polyakov will ensure that your stay in hospital is as comfortable as possible.
Contact Dr Polyakov if pain and nausea does not go away or is becoming worse. You should avoid strenuous activities or exercise until you recover completely. Most women will take two weeks off work and return to work at the start of the third week. Dr Polyakov will review you again one week after your discharge from hospital.
You may have some vaginal discharge (old blood) for several days after the procedure. You can return to normal activity after two weeks but complete recovery may take longer.After the procedure, you will no longer be menstruating and be unable to conceive. Avoid intercourse for 6 weeks to allow top of vagina adequate time to heal.
Many women are concerned by a possible change to sex. Many women can feel liberated now they are free of troublesome bleeding, pain with periods, discomfort from prolapse and no further need for contraception. Libido can be improved with an improvement in wellbeing.
Possible Risks Of A Laparoscopic Hysterectomy?
As with any surgical procedure, there are associated risks and complications which include:
Any specific risks and complications will be discussed prior to the procedure.
Ask for a second opinion
Dr Polyakov performs 99% of hysterectomies as a Total Laparoscopic Hysterectomy procedure.Laparoscopic hysterectomy has benefits such as shorter recovery period, with faster return to usual activities, reduced postoperative pain, minimal scarring and less risk of post-operative adhesions. Few gynaecologists have the skills necessary to perform a Total laparoscopic hysterectomy. Most hysterectomies in Australia are still performed open (Open Abdominal Hysterectomy).
Please make an appointment to see me for a second opinion if you have been advised to have a Open Abdominal Hysterectomy and before you commit to having a large scar.
Are there other alternative to this treatment?
There are other conservative interventions which may be appropriate for your particular condition. Dr Polyakov will discuss the other options with you to help you make a well informed decision regarding what is right for you.
Dr Polyakov will discuss with you the role for removal of the ovaries. Removal of the ovaries is recommended for women over the age of 50 years. If the ovaries are not removed you will not experience menopausal symptoms including hot flushes and night sweats.
How is a Laparascopic Hysterectomy Performed?
The procedure is done under general anesthesia in the operating room. A small incision is made just below your umbilicus. The abdomen is inflated with gas and a fibre-optic instrument called laparoscope is inserted to view the internal organs.
Three other small incisions are be made on your abdomen through which tiny surgical instruments are passed. Then, the uterus, cervix and tubes are removed along with or without both ovaries.
The current recommendation is to concurrently remove both tubes as this has been shown to be associated with a lower incidence of ovarian cancer. Total operating time is about 90 minutes.
What precautions should be taken before a Laparascopic Hysterectomy?
You can continue taking your regular medications, unless Dr Polyakov advises otherwise. If you take non steroidal anti-inflammatory medication Dr Polyakov will recommend that you discontinue this one week prior to surgery.
You will need to have a bowel preparation which will empty your bowel before the surgery. For this, you should be on a liquid diet (soups, jellies, juices or similar drinks) for 24 hours before the surgery. Our Practice Manager will provide you with instructions on this.
You will be admitted to hospital on the day of your operation. You will meet the anaesthetist to discuss the anaesthetic and any concerns you may have.
What is Vaginal Hysterectomy?
Vaginal hysterectomy is an alternative surgical procedure to abdominal hysterectomy. In this procedure, the uterus is removed through the vagina rather than through the incision in the abdomen.
What are the advantages of the vaginal hysterectomy over abdominal hysterectomy?
Recovery following vaginal hysterectomy is much faster than abdominal hysterectomy. You may be discharged from the hospital in a day or two and you can return to your daily activities within a few weeks after the surgery.
Who are the good candidates for Vaginal Hysterectomy?
Individuals with the following conditions and those who don't have enlarged uterus are considered as eligible candidates for vaginal hysterectomy.