Different types of hysterectomy

In the article ‘What is a Hysterectomy?‘ I talked about the fact a hysterectomy is the removal of the uterus, and NOT the removal of the ovaries. There are several different types of hysterectomy:

Total hysterectomy (also referred to as a standard hysterectomy) – removal of uterus
Supracervical (or Sub-total) hysterectomy – removal of uterus but cervix is left in place
Radical hysterectomy – a surgery done to treat some cancers of the cervix. Removal of the uterus, cervix, some ligaments and tissue, and an inch or two of the vagina.
It’s worth noting there that the radical hysterectomy – the one only done to treat certain types of cancer, is the only one that will shorten the vagina. This should not happen with a normal hysterectomy, there is no need to remove any part of the vagina.

 

As well as those definitions there are different ways a hysterectomy can be performed:
Abdominal (also referred to as open) hysterectomy – an incision, similar to a c-section, is made in the abdomen. Occasionally this incision is made vertically instead, if the uterus is particularly large (main cause would be large fibroids).
Laparoscopic hysterectomy – a minimally invasive surgical option; 3-5 small incisions are made in the abdomen and a small camera inserted, usually through the belly button. The surgery is carried out by using the image from the camera to guide the medical tools.
Vaginal hysterectomy – the least invasive surgery; everything is done through the vagina, there are no incisions made in the abdomen.
Laparoscopically-Assisted Vaginal hysterectomy – surgery conducted through the vagina but there are also instruments inserted through small incisions in the abdomen. This is normally done if the uterus is too large to be removed as one piece through the vagina and needs to be cut into pieces.
Robotic hysterectomy – 5 small incisions are made and a surgeon guides robotic instruments to remove the uterus.

 

From these types we get the general abbrevations for surgery which you may have seen online:
TAH – Total abdominal hysterectomy
LAVH – laparoscopic-assisted vaginal hysterectomy
TVH – total vaginal hysterectomy
SAH – supra-cervial (or sub-total) abdominal hysterectomy

 

Of course all this now leads to another question… which of these options is right for you? For the sake of keeping these articles reasonably short I’ll talk about that separately: read the article here.