Understanding Hysterectomy

  Hysterectomy is one of the most common surgical procedures in gynecology, but there is a lot to learn about it, and most patients and relatives do not know about it, and most mistakenly believe that all hysterectomies are performed in the same way. The following is a brief introduction to hysterectomy.  1. Intrafascial total hysterectomy. This is the most commonly performed hysterectomy in general gynecology, and is also a total hysterectomy in the usual sense. For example, total hysterectomy for benign lesions such as fibroids is performed in this way.  2.Extrafascial total hysterectomy. Also called an extended total hysterectomy, it means that a small amount of parametrial tissue (usually about 1 cm) next to the cervix is to be removed and 1 cm of the vagina is to be removed. This type of surgery is used for carcinoma in situ of the cervix, early endometrial cancer, etc.  3.Sub extensive hysterectomy. It means that both parametrial tissue and vagina should be removed at least 2 cm. this operation is suitable for stage Ia cervical cancer, early stage endometrial cancer, etc.  4.Extensive total hysterectomy. It means the parametrial tissues and vagina should be removed for more than 3cm. This surgery is suitable for cervical cancer stage Ib-IIa, etc.  The difference between the above 4 basic surgical methods is that the extent of resection of parametrial tissue (each ligament of the uterus) and vaginal tissue is different, and the extent of resection from top to bottom is from small to large. The greater the extent of hysterectomy, the more complex the surgical operation and the greater the risk of postoperative complications. Therefore, each procedure has its own strict indications, the aim of which is to ensure both surgical results and to reduce the risk of complications.