Christchurch Women's Hospital

Gynaecology Services - Hysterectomy

Hysterectomy has special significance for many women. For some it may conflict with traditional concepts of fertility and motherhood, while for others it represents a loss of part of their body or fear of the unknown. These fears and concerns need to be recognised and taken seriously.

A hysterectomy is an operation to remove the uterus (womb). The uterus lies in the pelvis, is about the size of a pear, with the bladder in front of it and the rectum behind.

Before After

Abdominal Hysterectomy

An abdominal hysterectomy means having your uterus removed through a cut in your abdomen (tummy) . This is made either vertically, from the navel down, or horizontally, just above the "bikini line" (approximately 14-16 cm long).

An abdominal hysterectomy is used if:

The tubes or ovaries must be removed
The uterus is quite large
There are other abdominal problems such as endometriosis or adhesions.

An abdominal hysterectomy is also used when the ovaries and pelvic cavity need to be inspected for disease.

Vaginal Hysterectomy

A vaginal hysterectomy means the removal of your uterus through your vaginal opening rather than through a cut in your abdomen. The only incision made is internally.

For a vaginal hysterectomy to be performed, the Doctor should be able to remove your uterus easily, e.g. where you have a prolapsed uterus that has dropped down into your vagina.

Instances where it may be more difficult are:

If the ligaments that hold the uterus in place are still firm
If your vagina is too narrow
If your uterus is enlarged by a tumour.

Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

A laparoscope is used for an LAVH. A laparoscope is the instrument used, rather like a narrow telescope about the width of a pen. It uses a fibre optic light system to enable the Doctor to see into the abdomen.

The laparoscope is placed through a 2cm cut below the umbilicus (tummy button) and is used to examine the pelvic organs. Two or three additional 2cm cuts are made below and to each side of the umbilicus to allow instruments to be inserted to assist with the surgery. The Surgeon cuts and frees the ligaments which support the upper part of the uterus, making it possible for it to be removed through the vagina. The incisions are closed with stitches.

Laparoscope

After the Uterus has been Removed

Once the uterus has been removed, by either the abdominal or the vaginal method, the lining of the vagina is stitched together at the top end to seal the pelvic cavity.

The space left after the uterus has been removed is filled by the bowel.

The information in this page has been drawn from a variety of sources, primarily the following books:

Hysterectomy

Sandra Coney and Lynn Potter (Heinemann Reed 1990)

Hysterectomy Information Package

Southern Canterbury Women’s Wellness Centre

Staff at Christchurch Women's Hospital

So You're Having a Hysterectomy

Megan Gressor (Gore & Osment Publications)

Some illustrations by Marisa Swanink

Cervical Cancer: A book for Every Woman.

More info about Gynaecology Services