Abdominal Hysterectomy

This operation is indicated when the vaginal route is not deemed suitable. This may be due to previous surgery, suspected additional pathology or sheer size.

The cut is often made on a previous caesarean scar and is generally a bikini cut. In rare circumstances, a vertical incision is made below the belly button. Muscles are split and not cut, thus function is not affected & you will be able to do those sit-ups again 6 weeks after surgery!

Once inside, a little time is taken to restore anatomy, that is to ensure the womb and ovaries are correctly orientated and free of attachments to

surrounding organs (called adhesions). The womb is then removed using sutures and/or electrocautery. The vaginal vault is sutured onto the supporting ligaments to guard againts later prolapse or sagging. The ovaries are generally retained and are secured to the pelvic side wall. Ovaries are generally only removed where compromised such as in suspected cancer or extensive benign disease.

The abdomen is closed in 3 layers, firstly the covering membrane or peritoneum, thereafter the muscle sheath and finally hidden sutures below the skin. I use a comfeel dressing which acts like a second skin, preventing movement at the scar and eliminating the risk of unsightly keloid. Please refer to 'do's & don'ts for abdominal surgery for post operative guidelines.

Abdominal Hysterectomy

Dr Douglas Seton, Obestetrician & Gynaecologist Knysna © 2021

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