Laparoscopic vs. open surgery for uterus removal: Which one is best

Dr.Madhulika Sinha, 3 mins read

Hysterectomy or uterus removal surgery is a treatment option for a range of conditions, like uterine fibroids, severe endometriosis, cancer, etc. Both open and laparoscopic surgeries have been in use for a long time. But which one is best? Or is there any alternative to uterus removal? This blog will delve into these questions.

What is a hysterectomy?

Hysterectomy is a surgical process to remove the uterus. Sometimes, it also involves removing the cervix, fallopian tubes, and ovaries, depending on the reason for the surgery. This surgery is usually referred to those who are not planning pregnancy. 

Types of hysterectomy

Depending on your condition, the surgeon will decide on what other parts need to be removed along with the uterus. Based on this, there are primarily four types of uterus removal surgery.

• Supracervical hysterectomy: Removes the uterus, not the cervix. Fallopian tubes and ovaries may or may not be removed. Periods will stop immediately after surgery. However, you will need to undergo a periodic Pap smear test as suggested by your doctor, as the cervix is still intact. 
• Total hysterectomy: Involves removing only the uterus and cervix, but periods stop immediately after surgery. Your ovaries may work till your natural menopause. 
• Total hysterectomy with bilateral salpingo-oophorectomy: Removes the uterus, cervix, fallopian tubes, and ovaries. Menopause will happen immediately after surgery. 
• Radical hysterectomy with bilateral salpingo-oophorectomy: Involves removing the uterus, cervix, fallopian tubes, ovaries, upper portion of the vagina, and some surrounding tissues and lymph nodes. Periods will stop immediately after surgery. 

What does a hysterectomy treat?

Hysterectomy is usually a last treatment option. When non-surgical and other alternatives don’t give relief, this procedure is usually considered. It can help in the treatment of:

• Abnormal or heavy vaginal bleeding
• Severe pelvic pain
• Uterine fibroids and other noncancerous tumours
• Severe endometriosis
• Uterine prolapse
• Cervical, ovarian or uterine cancer
• Uterine rupture or damage to the lining of the uterus
• Precancerous lesions

Laparoscopic Vs. Open surgery for uterus removal

Open or abdominal hysterectomy

It is a conventional approach wherein a cut of 6 to 8 inches is made in the abdomen. It is usually recommended in case of cancer, an enlarged uterus or when the disease has spread to other pelvic areas. The procedure usually requires a longer hospital stay and recovery period. 

Laparoscopic hysterectomy 

This is done through the abdomen. Contrary to open surgery, laparoscopic surgery requires small incisions, which means shorter hospital stay and faster recovery. During the procedure, the surgeon inserts a laparoscope (Attached with a camera, light, and surgical equipment) through the incision to cut and remove the damaged part through vagina in small pieces.

Robotic-assisted hysterectomy 

Robotic-assisted surgery is one of the latest surgical approaches. It is an advanced version of laparoscopy. The incisions are the same as laparoscopic surgery, recovery is much faster, and the risk of complications is lower. 

Note: Discuss with your doctor which option would be more appropriate for your overall condition. 

Alternative option

A non-surgical approach called uterine artery embolisation (UAE) is one of the best treatments for some complications that otherwise need hysterectomy. It involves injecting small particles called embolic agents into the uterine artery that supplies blood to the uterus. Consult our experts now for more information.