Panghysterectomy - types of operation, stages of implementation, rehabilitation
The operative intervention, during which the uterus is removed along with the appendages, is called a panhysterectomy. This type of surgical treatment is used only in limited cases - for malignant tumors that are not amenable to radiation therapy, for benign formations in the uterus. Extended extirpation of the uterus is a complete removal of the hollow organ with appendages and neck. Such surgical intervention belongs to the category of time-consuming and long-term, has clear contraindications for carrying out:
- uterine enlargement;
- Cesarean section in history;
- childbearing age (there are exceptions that apply to malignant neoplasms).
Doctors prefer to perform an operation to remove the uterus and appendages after a woman reaches menopause.
Types of extirpation of the uterus with appendages
There are several types of surgical intervention. The classification depends on the method of access to the uterus and appendages:
- laparoscopic extirpation of the uterus;
- vaginal access;
- laparotomy removal with an incision on the front wall of the peritoneum.
Doctors prefer the laparoscopic method, because it is a minimally invasive intervention with little trauma and a short rehabilitation period.
Before the method of surgical removal of the uterus with appendages (or without) is finally chosen, the patient must undergo a complete examination and pass the necessary tests. The doctor must be sure that there are no contraindications before the operation.
How the uterus is extirpated
The considered type of surgical intervention is carried out in several stages:
- The course of surgery for vaginal extirpation of the uterus or laparotomy begins with an incision and revision of the organs.
- Then the lower part of the intestine is pushed aside with a sterile napkin and the large ligaments are tied or cut.
- The uterus is diverted to the left and back, and all manipulations with the ligaments are performed on the right side.
- Clamped ligaments are cut, first of all, in those places where there are no blood vessels - in this way, it is possible to prevent the development of bleeding in the postoperative period.
- The folds between the uterus and bladder are cut. Bended scissors are inserted into the resulting space.
- After the described manipulations, the doctor sews a round ligament.
The second stage of the operation to remove the uterus with appendages consists in ligation of the ligaments of the ovaries and fallopian tubes. After that, the appendages are cut off from the uterus - this manipulation is performed with extreme caution, because there is a high risk of rupture (damage) of the ureters.
The final stage - the bladder is moved to the side to access the uterus with the cervix. After that, all ligaments are cut. The vessels are immediately clamped and sutured.
After extirpation of the uterus with appendages, a woman has to go through a long recovery period.
Rehabilitation after surgery to remove the uterus with appendages
Recovery after surgery is difficult - psycho-emotional problems often arise. The realization that the internal female organs have been completely removed can lead to depression, apathy and even suicide attempts. Such consequences of extirpation of the uterus are corrected only by a psychotherapist. A patient who has undergone such surgical treatment must be referred for an appointment with a specialist. The problem is aggravated even more by the lack of sexual desire - in this case, not only a visit to a psychologist will help, but also hormonal, sedative drugs, which are prescribed purely individually.
Monthly discharge after extirpation of the uterus usually stops, although some women may persist. This is possible only in one case - a woman is forced to constantly take hormonal drugs, although this is an exception. The fact of cessation of menstruation affects the psyche, especially if the operation was performed on a woman of childbearing age.
There is a separate question about radiation therapy after removal of the uterus with appendages. Such appointments are made to patients who have previously been diagnosed with a malignant tumor. This is done to prevent relapse. The rehabilitation period in this case will be longer, because the woman needs to recover not only after surgery, but also after radiation exposure.
Extirpation of the uterus with appendages is a difficult operation not only for the patient, but also for the medical staff: you need to have specific knowledge and experience. An important role is played by the preparatory period. You can learn more about it and the intricacies of panhysterectomy on the pages of our website https://dobrobut.com/.
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