In order to gain access to the inside of the body, surgeons sometimes choose to create a large incision because it provides an open view of the internal organs. This type of procedure is often called an “open procedure.” The most commonly performed hysterectomy is an open procedure called a total abdominal hysterectomy (TAH). In this “traditional” procedure, the surgeon removes the uterus, including the cervix, through a five-inch abdominal incision. The large incision leaves a visible scar on your abdomen, making the TAH the most invasive of hysterectomy types. 

During a TAH, the tissues of the abdominal wall are stretched apart and the uterus is removed through the incision. Recovery time is usually longer and the overall level of discomfort may be greater following a TAH than following a Minimally Invasive hysterectomy. A TAH typically requires a hospital stay of three to five days. Normal activity can usually resume in six weeks.

For certain conditions or situations, a TAH may be the recommended procedure.

Minimally Invasive Procedure (MIP)  is another way for the surgeon to perform a hysterectomy.  MIP uses state-of-the-art technology to treat more than 300,000 hysterectomy patients every year.  Women who have a MIP often experience faster recovery, shorter hospital stays, and less pain and scarring than women who have a TAH.

A Vaginal Hysterectomy (VH)  is performed through an incision made at the top of the vagina.  Through this vaginal incision, the uterus, including the cervix, is separated from the surrounding tissues and then removed through the vagina.  Your ovaries and fallopian tubes can be removed from the vaginal incisions if needed.  The vaginal incision is small, heals quickly, and does not leave an external scar.  VH takes one to two hours to perform and requires an over-night stay in the hospital.  Normal activity can usually resume in four weeks.

Laparoscopic Assisted Vaginal Hysterectomy (LAVH) is similar to a vaginal hysterectomy in that the uterus and cervix are removed through an incision at the top of the vagina.  However, prior to this removal, Dr. Imtiaz uses a laparoscope (a miniature camera) inserted into the abdomen.  Then two to three small incisions are made in the lower abdomen to allow the passage of specialized instruments to aid with the surgery.  The laparoscope allows her to view the outside of the uterus and surrounding organs.  The uterus is detached under the view of the laparoscope using specialized surgical tools.   The uterus is removed from the vagina and the vaginal incision is closed through the vagina.  Post-operatively you will remain in the hospital over-night.  A large number of patients are able to return to work in about two weeks.

Total Laparoscopic Hysterectomy (TLH)  is a newer procedure requiring advanced surgical techniques.  During this procedure a laparoscope is inserted through the abdomen and two to three small incisions are made in the lower part of the abdomen.  Using special surgical tools and the laparoscopic camera Dr. Imtiaz can detach the uterus (and if indicated the ovaries and tubes) from the surrounding tissue.  The specimen is removed from the small abdominal incisions.  In this procedure no vaginal incisions are made and therefore, the recovery often is improved over an LAVH.  This type of surgery often requires an overnight stay.  You will be discharged from the hospital in less than 24 hours and most patients are able to return to work in two weeks. 

Laparoscope Supra-cervical Hysterectomy (LSH) is a type of minimally invasive option for the patient.  In this procedure TLH techniques are used and the uterus is removed, however, the cervix is left in place.  For some patients leaving the cervix lessens the risk of future prolapse and often results in minimal sexual response disruption.  After this type of surgery you must continue to have routine pap smear exams to screen for cervical cancer.  Hospital stays and recovery times are similar to TLH.