supracervical hysterectomy


Also found in: Dictionary, Thesaurus, Acronyms, Encyclopedia.

su·pra·cer·vi·cal hys·ter·ec·to·my

removal of the fundus of the uterus, leaving the cervix in situ.

supracervical hysterectomy

(so͞o′prə-sûr′vĭ-kəl)
n.
Surgical removal of the fundus of the uterus, leaving the cervix in place.

su·pra·cer·vi·cal hys·ter·ec·to·my

(sū'pră-sĕr'vik-ăl his'tĕr-ek'tŏ-mē)
Removal of the fundus of the uterus, leaving the cervix.

hysterectomy

(his?te-rek'to-me) [ hystero- + -ectomy]
Enlarge picture
HYSTERECTOMY
Enlarge picture
HYSTERECTOMY
Enlarge picture
HYSTERECTOMY
Surgical removal of the uterus. Each year, about 500,000 women undergo hysterectomies. Indications for the surgery include benign or malignant changes in the uterine wall or cavity and cervical abnormalities (including endometrial cancer, cervical cancer, severe dysfunctional bleeding, large or bleeding fibroid tumors (leiomyomas), prolapse of the uterus, intractable postpartum hemorrhage due to placenta accreta or uterine rupture, or severe endometriosis). The approach to excision may be either abdominal or vaginal. The abdominal approach is used most commonly to remove large tumors; when the ovaries and fallopian tubes also will be removed; and when there is need to examine adjacent pelvic structures, such as the regional lymph nodes. Vaginal hysterectomy is appropriate when uterine size is less than that in 12 week gestation; no other abdominal pathology is suspected; and when surgical plans include cystocele, enterocele, or rectocele repair. illustration;

In preparation for abdominal hysterectomy, the patient is placed in the dorsal position. The table is ready to be tipped into the Trendelenburg position. As soon as the incision is made through the peritoneum, the table should be put into the Trendelenburg position. This procedure is the same for all abdominopelvic surgery, as the Trendelenburg position allows the abdominal organs to fall away from the pelvis so that they may be easily packed off and isolated from the surgical field with large pads or a large roll of packing.

Patient care

Preoperative: In general, preparations for an abdominal hysterectomy are similar to protocols for any abdominopelvic surgery (e.g., abdominal skin preparation, insertion of an intravenous line and, depending on surgical protocol, an indwelling urinary catheter). Vaginal irrigation with antibacterial solution also may be ordered. All procedures are explained to the patient, who is provided with anticipatory guidance for the postoperative period. Misconceptions are clarified, informed consent is validated, and the signing of the operative permit is witnessed. The patient may be encouraged to discuss the personal meaning and implications of the procedure, such as permanent inability to bear children; emotional support is given. The gynecologist and nurses should make available opportunities for the patient to ask questions and receive information about sexual concerns and be provided with resources (or a way to access resources), or specialist referrals for further information as desired. Controlled trials that have studied large numbers of women have not shown, in aggregate, any adverse effect of hysterectomy on sexuality (good sexual function is retained or regained; however the nature and quality of sexual response may change) or women's perceptions of their femininity.

Postoperative: Initial status assessments include color; vital signs; airway patency and breath sounds; level of consciousness and discomfort; intravenous intake; and nasogastric and indwelling catheter drainage. During the first few hours, assessments usually are made over lengthening intervals, from every 10 to 15 minutes during the first hour to every 30 minutes to hourly. Intervals and assessment priorities may be altered on the basis of current findings, such as bleeding. Color; vital signs; airway patency and lung sounds; level of consciousness and discomfort; intake and output (including intravenous fluids, nasogastric and indwelling catheter drainage); and abdominal dressings (intact, amount and character of any drainage) are monitored. Additional later assessments include bowel sounds; lower extremity circulation (pedal pulses, leg pain); and wound status (redness, edema, ecchymosis, discharge, and approximation). The patient is encouraged to splint the incision, turn from side to side, use incentive spirometry, deep breathe and cough every 2 hr, and use incentive spirometry. Prescribed intravenous fluids and analgesics are administered. The woman is assisted in self-administering patient-controlled analgesia. Antithromboembolitic devices (pneumatic dressings or elastic stockings) are applied as needed. The patient is encouraged and assisted with early ambulation. The patient is encouraged to splint the incision, turn from side to side, deep breathe and cough every 2 hr, and use incentive spirometry.

If the patient's ovaries have been removed, the reasons for hormone therapy are explained to her. Effective coping strategies related to anticipated radiation and/or chemotherapy are targeted. Desired outcomes include evidence of incisional healing; absence of complications; return of normal GI and bladder function; and understanding of and compliance with the prescribed treatment regimen.

abdominal hysterectomy

The removal of the uterus through an abdominal incision.
Synonym: abdominohysterectomy

cesarean hysterectomy

The surgical removal of the uterus at the time of cesarean section.

pan hysterectomy

Removal of the uterus, fallopian tubes, and ovaries.

radical hysterectomy

The surgical removal of the uterus, tubes, ovaries, adjacent lymph nodes, and part of the vagina.

subtotal hysterectomy

A procedure in which the cervix is left intact after the uterus has been removed. The cervix, which acts as an anchor, and upper vagina are preserved, resulting in better support of the remaining structures. Most women experience less discomfort and faster recovery with this procedure than with a total hysterectomy. Routine pap screening following this procedure is recommended. Any woman with a history of abnormal pap tests or cervical cancer is not a candidate for subtotal hysterectomy. Synonym: supracervical hysterectomy; supravaginal hysterectomy

supracervical hysterectomy

Subtotal hysterectomy.

supravaginal hysterectomy

Subtotal hysterectomy.

total abdominal hysterectomy

Removal of the uterus, including the cervix, through an abdominal incision.

vaginal hysterectomy

The surgical removal of the uterus through the vagina.
References in periodicals archive ?
Busund, "Risk of morcellation of uterine leiomyosarcomas in laparoscopic supracervical hysterectomy and laparoscopic myomectomy, a retrospective trial including 4791 Women," Journal of Minimally Invasive Gynecology, vol.
Among the various laparoscopic approaches to hysterectomy, laparoscopic supracervical hysterectomy (LSH) is the least invasive and continues to grow in popularity among laparoscopic gynecologic surgeons.
Laparoscopic supracervical hysterectomy with laparoscopic in-bag morcellation is a safe and feasible minimal-access surgery even in very large uteri of more than 1400 g.
Patients also should be counseled about a risk for developing cancer in the cervical stump after supracervical hysterectomy, added Dr.
In my opinion, the proponents of supracervical hysterectomy have not shown that it's safer or results in improved health.
My total abdominal hysterectomy and laparoscopic-assisted vaginal hysterectomy rates remain less than 5%; laparoscopic supracervical hysterectomy and total laparoscopic hysterectomy rates: 0%; and power morcellation rate: 0%.
Over time, there was a shift from laparoscopic-assisted vaginal hysterectomy to laparoscopic-assisted supracervical hysterectomy using the morcellator.
Iatrogenic endometriosis caused by uterine morcellation during a supracervical hysterectomy. Obstet Gynecol.
-- Applying a paracervical block before laparoscopic supracervical hysterectomy improves some operative outcomes but not others, Dr.
Kho: I infrequently perform supracervical hysterectomy, so almost all the hysterectomies I do are total hysterectomies.
Among the many limitations of the study that make it of almost no value is the fact that most patients in the nonrobotic group underwent supracervical hysterectomy. In the first instance, supracervical hysterectomy is a procedure of greatly dubious benefit for most women.
This goes for hysterectomy involving a large uterus, myomectomy through a culdotomy incision, and removal of the uterine fundus after supracervical hysterectomy. (It is irresponsible to use expensive power morcellation to remove small supracervical hysterectomy specimens.) It is time to get back to learning and teaching vaginal morcellation, although I readily admit it is time consuming.