Understanding Hysterectomy


First, some basic facts about hysterectomy:

*A hysterectomy is the surgical removal of the uterus (hyster = uterus, ectomy = surgical removal).

*A hysterectomy is a fertility-ending procedure.

*A hysterectomy is not a cure for endometriosis (even if you also have bilateral salpingo-oophorectomy  which is removal of tubes/ovaries), and, in a lot of cases, is not necessary to effectively treat the condition. If you have endometriosis, consider consulting with a specialist expert surgeon who can excise or “cut out” the endo lesions (completely different from the burn off methods used by average OB/GYNs). Often times, this can be effective in removing the DISEASE while leaving you with your organs intact. You can watch my story of overcoming endometriosis almost 7 years ago – without the loss of ANY reproductive organs – and conceiving a child naturally with fertility sparing excision surgery here.

*A hysterectomy is considered the definite treatment for adenomyosis (not to be confused with endometriosis).

*It’s a common MISCONCEPTION that a “partial” hysterectomy means ovaries left, “full” or “complete” or “radical” means “all reproductive organs removed”. THIS IS MEDICALLY INACCURATE.

*A hysterectomy, whether partial or total, refers ONLY to the uterus and cervix – no other organs. There is nothing in the term “hysterectomy” that refers to ovaries and/or tubes. Removal of ANY organ that isn’t the uterus, even if it is done during the same surgery, is a separate/additional procedure – it is not part of a hysterectomy itself.*The cervix is the neck or lower part of the uterus – as such, a “partial” “sub-total” or “supracervical” hysterectomy means that the uterus was removed, but part of it – the cervix – (hence “partial”) was left behind.*A “total” hysterectomy means the entire uterus – including cervix – was removed.

*A “radical” hysterectomy involves the removal of the uterus/cervix, upper vagina, parametrium (the fibrous band of tissue that separates the supravaginal portion of the cervix from the bladder); often involves salpingo-oophorectomy (tubes/ovaries removed), as well as staging of cancer using lymph nodes. This is typically only performed in cancer patients.

*A hysterectomy is a surgery you can only have once. If you have your uterus removed, and later have your ovaries and/or tubes removed, that is not “two hysterectomies”.

*Removal of ovary(ies) is an oophorectomy, not a hysterectomy. Removal of Fallopian tubes is a salpingectomy. Removal of both tubes and ovaries together is called a bilateral salpingo-oophorectomy.

Abbreviations/Helpful Terms/Commonly Related Procedures:

T = Total (in this case, entire uterus including cervix)
S = Supracervical or Subtotal (uterus leaving cervix behind)
A = Abdominal (can also stand for “assisted” when used in term LAVH)
V = Vaginal
H = Hysterectomy
TLH = Total Laparosopic Hysterectomy
LSH = Laparoscopic Supracervical Hysterectomy
TVH = Total Vaginal Hysterectomy
LAVH = Laparoscopic Assisted Vaginal Hysterectomy
dvTH = Total Hysterectomy using daVinci
dvSH = Supracervical Hysterectomy using daVinci
TAH = Total Abdominal Hysterectomy
SAH = Supracervical Abdominal Hysterectomy
Oophorectomy = removal of ovary(ies)
Salpingectomy = removal of tube(s)
Unilateral = one
Bilateral = both
BS = Bilateral Salpingectomy (removal of both fallopian tubes, ovaries left remaining)
BSO = Bilateral Salpingo-Oophorectomy (removal of both tubes/ovaries)
RSO = Right Salpingo-Oophorectomy (removal of right tube/ovary)
LSO = Left Salpingo-Oophorectomy (removal of left tube/ovary)To successfully abbreviate your surgery, simply find the term for your specific type of hyster and then add any additional procedures using a + sign.
Example: Total Laparoscopic Hysterectomy + Bilateral Salpingectomy = TLH+BS
(removal of uterus/cervix + fallopian tubes using the laparoscopic approach).

Explanations of the Various Types of Hysterectomy:

Total Laparoscopic Hysterectomy or “TLH” –
In this surgery, 2-5 small incisions are made on the abdomen, however, no vaginal incision is made (although the vagina is used for organ removal). Surgery is performed entirely using the laparoscope. Uterus/cervix removed through the vagina intact and then the vaginal cuff is created. https://www.youtube.com/watch?v=gMMJIvwjOD4

Laparoscopic Supracervical Hysterectomy or “LSH” –
Surgery performed entirely using laparoscope. Using a tool called a morcellator, the uterus is cut into pieces and then removed through the abdomen. Cervix remains.

Laparoscopic Assisted Vaginal Hysterectomy or “LAVH” –
In this surgery, 2-5 small incisions are made on the abdomen, as well as an incision made vaginally. The surgery combines the vaginal and laparoscopic approach. The uterus is removed vaginally.

Total Vaginal Hysterectomy or “TVH” –
In this surgery, a cut is made vaginally. No incisions are made on the abdomen.
The surgery is performed entirely through the vagina. Uterus/cervix are removed vaginally.

DaVinci Total Hysterectomy or “dvTH” –
Removal of uterus and cervix using robotic-assisted technology. http://www.methodisthealthsystem.org/daVinciHysterectomyAnimation

DaVinci Supracervical Hysterectomy or “dvSH” –
Similar to a daVinci total hyster, the variation here is that the cervix is left behind. https://www.youtube.com/watch?v=btOqKqtxsG0

Total Abdominal Hysterectomy or “TAH” –
This surgery removes the uterus/cervix using a c-section style incision. https://www.youtube.com/watch?v=050kjJpsNLg

Supracervical Abdominal Hysterectomy or “SAH”-
Similar to a TAH, the variation here is that the cervix is left behind. https://www.youtube.com/watch?v=050kjJpsNLg


About ducksinarow55

Wife. Mommy. Endometriosis/Adenomyosis/Bell's Palsy warrior. Advocate for advanced excision surgery as the gold standard treatment for endometriosis. My posts will include my personal journey with both endometriosis and adenomyosis, as well as links to resources by reputable endometriosis/adenomyosis sites (ie. Endometriosis Research Center, World Endometriosis Research Foundation, etc). Follow me on twitter - twitter.com/rlgibson
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