Hysterectomy for Endometrial Cancer

A hysterectomy is the surgical removal of a woman's Reference uterus Opens New Window Reference Opens New Window. A hysterectomy to remove Reference endometrial cancer Opens New Window usually includes the removal of the Reference ovaries Opens New Window and Reference fallopian tubes Opens New Window (bilateral salpingo-oophorectomy). Your doctor will also do a pelvic and para-aortic lymph node biopsy to find out the stage and grade of the cancer. Most cases of endometrial cancer are diagnosed during the earliest stage, while cancer is still contained in the uterus and can be cured.

Your surgery will depend on how much of your reproductive system may be affected by endometrial cancer.

• A total hysterectomy is the removal of the uterus and Reference cervix Opens New Window.
• A total hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes, and ovaries. This is the most common surgery done for endometrial cancer.
• A radical hysterectomy is the removal of the uterus, cervix, surrounding tissue, upper vagina, and usually the Reference pelvic lymph nodes Opens New Window Reference Opens New Window. The number of lymph nodes removed depends on how far the cancer has spread.

A hysterectomy for endometrial cancer may be done with an incision (cut) in the abdomen. Sometimes a laparoscopic hysterectomy is possible. In both procedures, Reference general anesthesia Opens New Window usually is used. The type of hysterectomy you have depends on your medical history and general state of health and on the extent of the cancer growth. Medical centers and surgeons may prefer to do the type of surgery that they have more experience with. Pelvic and para-aortic lymph nodes will be biopsied during surgery to help find out the stage of cancer.

• Abdominal hysterectomy: The uterus, ovaries, and fallopian tubes are removed through an incision (Reference laparotomy Opens New Window) in the lower abdomen.
  • An abdominal incision provides a large opening into the abdomen for the surgeon to easily see the organs and to find out the extent of the cancer.
  • An abdominal hysterectomy will leave a scar (usually 5 inches) on the abdomen.
  • The usual stay in the hospital after an abdominal hysterectomy is 3 days.
• Laparoscopic hysterectomy: Laparoscopic surgery is done with a tiny camera and special instruments. The surgeon puts these tools through several small incisions (cuts) in the belly.
  • In a laparoscopic hysterectomy, the surgeon usually is able to see the organs well enough to find out the extent of the cancer.
  • A laparoscopic hysterectomy leaves several very small scars on the abdomen.
  • You usually stay in the hospital for 1 or 2 days after a laparoscopic hysterectomy.
  • In a laparoscopic hysterectomy, the uterus is detached and may be removed in pieces through the small incisions in the abdomen. Or it may be removed through the vagina.

When done by an experienced surgeon, laparoscopic hysterectomy may have a quicker recovery and fewer complications than abdominal hysterectomy.

Some surgeons do this surgery by guiding robotic arms that hold the surgery tools. This is called robot-assisted laparoscopy.

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