The hysterectomy surgical procedure can be performed several ways, vaginally, laparoscopically assisted, or open through the abdomen (abdominal hysterectomy). Regardless of the approach, a hysterectomy is an inpatient procedure that is done using general anesthesia.
Generally speaking, laparoscopic patients heal the quickest, with a return to work and activity as quickly as two weeks, while open hysterectomy patients required six to nine weeks to return to normal activity.
The approach varies with surgeon preference and the reason for the hysterectomy. A uterus with large tumors may not be able to be removed through the vagina or tiny laparoscopic incisions, but must be removed through the larger open incision. In most cases, the open approach is the least favored by surgeons, as blood loss is greater, recovery is longer and the risk of infection is higher.
Regardless of the approach used for the surgery, the procedure consists of separating the uterus from the ligaments and tissue that hold it in place and any scar tissue that may be present. It is then removed through the vagina or the abdominal incision.
Once the surgeon has inspected the tissue for any tumors or bleeding and determines that the surgery is complete, the instruments are withdrawn and any incisions are closed. Abdominal laparoscopic incisions may be closed with absorbable sutures and sterile tape while open incisions will be held closed with staples or sutures that are removed weeks later by the surgeon.