Abdominal hysterectomy
Nationally,
and indeed internationally, most hysterectomies are done abdominally. There is little
argument that it is the technique which is the most versatile and suitable in almost
every situation, with the added advantage that the entire abdomen can be palpated
(examined by hand). However, it is also the operation which requires the largest
skin incision and is associated with the longest recovery time. For these reasons,
there is a trend to carrying out fewer abdominal hysterectomies and relatively more
laparoscopic and in particular vaginal hysterectomies.
The usual skin incision for abdominal hysterectomy is a low, horizontal incision close to the pubic hair-line (see figure). However, if there are large fibroids or an ovarian cyst to remove, the incision may have to be vertical to provide sufficient space for the surgery.
Hospital stay after abdominal hysterectomy is typically 5 to 7 days, and most women take 6 weeks before they return to work.