Hysterectomy for endometrial cancer
The usual operation for endometrial cancer involves removing
the uterus, cervix, both Fallopian tubes and ovaries. The procedure
is called a total abdominal hysterectomy and bilateral salpingo-oophorectomy
(TAH & BSO for short).
Sometimes it is also necessary to remove the fat 'apron' in the
abdomen (called the omentum), in a procedure called omentectomy. Similarly,
the lymph glands in the pelvis may be removed.
The operation is carried out under general anaesthetic, usually
though a vertical (midline) or transverse (bikini- line) incision. A
catheter may be passed up the urethra into the bladder to drain off
the urine, and another tube may be inserted into the abdomen or vagina
to drain any bleeding in the pelvis. These tubes may be left in place
for 1-2 days.
Sometimes, the hysterectomy is performed using keyhole surgery.
A narrow telescope called a laparoscope is inserted though a small cut
in the belly button. Keyhole surgery instruments are inserted into the
abdomen through other small cuts in the abdominal wall. The laparoscope
is used to perform the early steps of the hysterectomy, and the organs
are finally removed through the vagina. Lymph glands in the pelvis can
also be removed using the laparoscope.