Frequently Asked Questions About Laparoscopic Supracervical Hysterectomy
What is the uterus made up of?
The uterus is a thick muscular organ that consists of 3 parts: cervix, uterine body, and uterine fundus. The fundus is the upper portion of the uterus above where the fallopian tubes attach. The uterine body is the major portion of the uterus between the uterine fundus and cervix. The cervix is the lower part of the uterus that communicates with the vaginal canal. Hysterectomy (“hyster” means uterus, “ectomy” means to remove) is removal of the uterus.
How are total, partial, and supracervical hysterectomies different?
Removal of the entire uterus, including the cervix, is called total hysterectomy. Removal of the upper uterus (uterine body and fundus), conserving the cervix, is called partial hysterectomy. Since partial hysterectomy is above a portion of the cervix, this is also known as supracervical hysterectomy. These procedures can be done by laparotomy (open) or by laparoscopy (endoscopic).
How safe and common are hysterectomies?
Many years ago, before blood banks, antibiotics, and modern anesthesia, surgery was dangerous with high mortality. Surgical procedures were kept as short as possible, and all hysterectomies were partial hysterectomies. With the advent of blood banks, modern anesthesia, and antibiotics, total hysterectomies were performed. Total hysterectomy and supracervical hysterectomy are both good procedures being preformed today.
What is morcellation?
Morcellation is a procedure where a specimen, such as uterine fibroids, is removed in smaller pieces, allowing the surgeon to avoid making a large abdominal incision and perform these surgeries on an outpatient basis. Uterine fibroids have a small risk, an approximately 0.5% chance, of malignancy. If a uterine malignancy was morcellated, this could possibly spread the tumor and upstage the malignancy. Therefore, Dr. Robbins no longer performs morcellations. Uterine fibroids and the fibroid uterus are managed with laparoscopy, and then the specimens are removed from the abdomen through a small laparotomy incision. This practice allows for minimal discomfort from the laparotomy incision.