Health A-Z

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How It's Done

A hysterectomy takes about one to two hours. You will either be under general anesthesia or have regional anesthesia during the surgery. Regional anesthesia is by spinal or epidural injection of medicines to numb the lower half of your body. Before the procedure, an intravenous (IV) catheter will be inserted into one of your veins to deliver fluids and medications. What happens next depends on the type of hysterectomy:

  • Abdominal hysterectomy. The surgeon will make a 5-inch to 7-inch incision in your lower abdomen. The incision can be vertical (from the belly button to just above the pubic bone) or transverse (horizontal at the pubic-hair line, often called a "bikini incision"). The uterus is freed from its attachments to blood vessels and supportive tissues, and then is removed through the incision. Then the layers of the abdomen will be closed with sutures (stitches) and the incision may be closed with sutures or titanium (metal) staples. Staples or non-dissolving skin sutures usually are removed about one week after the surgery.

  • Vaginal hysterectomy. An incision will be made in the wall of the upper portion of your vagina. Through this incision, the surgeon will use sterile instruments to detach your uterus and to tie off nearby blood vessels. Your uterus will be removed through your vagina, and then the incision will be stitched closed. Once the vagina has healed, the length of the vagina should remain adequate for comfortable sexual intercourse.

  • Laparoscopic hysterectomy. Three or four small incisions are made in the wall of the abdomen to allow the surgeon to insert a laparoscope and additional surgical instruments. In some cases a robot is used to control the instruments. These instruments are used to help free the main body of the uterus and to remove the ovaries, if necessary. The uterus is then removed either through the vagina or through the small abdominal incisions. At the end of the procedure, the upper portion of the vagina is stitched closed and the small abdominal incisions are closed with sutures or surgical tape.

After your surgery, you will be taken to a recovery room. There, your vital signs (blood pressure, heart rate, breathing rate and temperature) will be monitored closely, and you will be given pain medication if needed. After a few hours, you will be taken to your hospital room to rest and to begin healing. Your IV line will be removed, and you will be allowed to eat as soon as your digestive system is ready to handle liquids and solid food. You may remain in the hospital for one to three days. During the first few days after your hysterectomy, you may have slight vaginal bleeding and discharge.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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