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Anal Fistula, Piles and Fissure are together known as Benign ano-rectal conditions. These conditions are not fatal but they are extremely agonizing..

What further increases the anxiety is the fact that their conventional treatment is even more traumatic and painful resulting in large wounds.

But now procedures are available which have made the treatment of these disorders virtually cut less, woundless and painless.




Single Hole Surgery - Scarless Surgery

You thought that a Surgery, even keyhole, always produces a scar. Not any more!

Uterus Surgery (Hysterectomy)           Gall Bladder / Appendix/ Hernia, click here

What is Hysterectomy (Uterus removal)?

A hysterectomy is the removal of the uterus (womb). Sometimes, the Fallopian tubes and ovaries are also removed, which is called Salpingo-oophrectomy. ( Salpingectomy= removal of fallopian tube, Oophrectomy= removal of ovary).

 What are the common  reasons for doing a Hysterectomy?

 The common reasons for doing a hysterectomy are

  • 1.        Fibroids-Benign tumors of the uterus (30% )

  • 2.       Abnormal Bleeding from uterus(20%)

  • 3.       Endometriosis (20%)

  • 4.       Genital prolapse (15%)

  • 5.       Chronic pelvic pain (10%)

  • 6.       Miscellaneous (5%). Uterine cancer is an uncommon, but important reason for doing a hysterectomy.

Are there different types and ways of doing Hysterectomy? If yes, how many?

Total hysterectomy The uterus and the cervix are removed.

Subtotal or partial hysterectomy The upper portion of the uterus is removed, leaving the cervix intact.  Usually done in cases where it’s difficult to remove cervix.

Hysterectomy with Salpingo-oophrectomy-  The uterus, cervix, fallopian tube and ovary is removed.

Radical hysterectomy The uterus, cervix and ovaries are removed. The surgery is more extensive with  removal of surrounding tissues and lymph nodes. Done in cases of cancer.

Depending upon the extent and invasiveness of operation, there are several ways the surgery can be performed:

Abdominal Hysterectomy This hysterectomy is performed using an incision in the abdomen (tummy) that can be either vertical from the area of the pubic bone up toward the belly button (navel), or it may be horizontal along the bikini line. The uterus is taken out through the abdomen incision.

Vaginal Hysterectomy This hysterectomy is performed entirely through an incision made in the vagina. This is usually possible in cases of Prolapse uterus (attachments of uterus become lax and uterus starts protruding out through the vaginal outlet).

 Laparoscopic Assisted Hysterectomy This is the hysterectomy done by Laparoscopic (keyhole) method and the uterus is taken out through the vaginal route.

Total Laparoscopic Hysterectomy In this laparoscopic method, the uterus is taken out through the abdominal holes (small incisions) after morcellation (cutting uterus in small pieces).

Single Incision Laparoscopic Hysterectomy or Scarless Hysterectomy  In this latest laparoscopic method, the surgery is done through a small single hole (incision) done through the belly button (navel). As the scar is inside the navel, it’s not visible after the operation making it virtually a ‘scarless’ operation.

What are the advantages of laparoscopic hysterectomy (Uterus removal)?


The advantages over the conventional hysterectomy are that there is minimal tissue handling resulting in much less pain and lesser chances of adhesion formation after the operation. 3-4 small incisions of 0.5-1.0 cm (as compared to 10-15cms in conventional procedure) are given on the abdomen resulting in less blood loss and lesser chances of wound infection with decreased hospital stay and early recovery as compared to conventional surgery.


What is Single Hole {Scarless} Laparoscopic Hysterectomy (Uterus removal)?

In Single Hole Surgery, the complete surgery is done through a single small puncture/hole/incision of about 1.5 to 2.5 cms. This small cut is made inside the navel (umbilicus) in such a way that the scar is practically invisible after the operation, making it a scarless surgery.

What is the advantages of Single Hole  Laparoscopic Hysterectomy?

As there is only one small cut (incision), the Single Hole Surgery is associated with:-

1. Less pain

2. Early discharge from the hospital

3. Early return to work

4. Less risk of wound infection

5. Lesser risk of hernia formation as no muscle is cut

6.Excellent cosmetic result as the operation is virtually scarless.


Who can undergo Single Hole Laparoscopic Hysterectomy?


Usually all the patients who have been advised for conventional hysterectomy can undergo Single Hole laparoscopic hysterectomy, provided the size of uterus is not very big (that is bigger than 20 cm).

A person with diabetes or hypertension can also undergo this procedure after the conditions are under control, and in fact the advantages of lesser chances of infection and early recovery are very beneficial for them.

A patient who has undergone operations in the past can also usually undergo this procedure and if there are adhesions because of previous operations, they can usually be removed along with the laparoscopic hysterectomy, in the same sitting.

It is also possible to treat or remove the ovaries and tubes while carrying out laparoscopic hysterectomy.



What preparation is needed before the procedure?


The usual routine tests are required as for any other operative procedure and no special investigation is required for Single Hole hysterectomy.

To make the operation easier, the recovery after the operation faster and resumption of normal work or activity earlier, some medicines (laxative and gas absorbers)  along with diet restriction is started a day before the operation. The purpose of this is to make bowels free of gas and fecal matter as much as possible.

After full investigations, the patient is usually admitted a day before the operation.


What happens after the procedure?


The total hospital stay is usually for two days, after which one can go back home.

On an average, two hours after lunch and eight hours rest after dinner is what is usually recommended. The patient can climb stairs slowly, walk half to one km slowly and carry out sedentary work at home without much difficulty. One can take  bathe usually on third to fifth day after the operation.

Routinely, the patient is called seven days after the operation for the removal of stitches and then after six weeks for an internal check up.



When can one resume normal activity or go back to work?


Once the stitches are removed, the patient can resume normal activity like walking, jogging, cooking, driving, sitting in front of the computers for 4-6 hrs etc. Sexual intercourse, strenuous exercise, lifting of heavy weights and swimming has to be avoided for eight weeks.

How is woman’s sex life after Hysterectomy?

Sex after a hysterectomy, in many cases, is as good or better than it was before surgery. Many women find that they no longer have to worry about birth control or having a period (the periods permanently stop after hysterectomy). In ladies with pain, being pain free is certainly an improvement.








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Dr Pankaj