St.
Paul College of Ilocos Sur
(Member, St. Paul University System)
St. Paul Avenue 2727, Bantay, Ilocos Sur
DEPARTMENT OF NURSING
Presented to
Department of Nursing
St. Paul College of Ilocos Sur
Bantay, Ilocos Sur
____________________
In Partial Fulfillment of the
Requirements for the Subject
NCM 108
Health Care Ethics (BIOETHICS)
____________________
by:
CACHOLA, Alexandra C.
BSN- II B
Submitted to:
Ms. Claire Riodil
NCM 108 INSTRUCTOR
2024
HYSTERECTOMY
INTRODUCTION
The first abdominal hysterectomy was carried out in 1843. Historically, vaginal
hysterectomy was used to cure uterine prolapse or inversion, which led to earlier
attempts to remove the uterus. Minimally invasive hysterectomy was made possible
with laparoscopic help in 1989, and it was made even easier in 2005 when the
robotic-assisted procedure was approved. Hysterectomy procedures performed
today include abdominal, vaginal, laparoscopic, robot-assisted, and a combination of
vaginal and laparoscopic procedures. The clinical indication, the surgeon's technical
skill, the available resources, the patient's overall health, and the patient's preference
all influence the surgical strategy for hysterectomy.
During an abdominal hysterectomy, the abdominal wall is cut in order to remove the
uterus. Abdominal hysterectomy rates have decreased as less invasive techniques
have become more widely available. These less invasive methods have advantages
like shorter hospital stays, lower costs, and improved short-term quality of life
following surgery. They also cause less pain and faster recovery. In addition,
hysterectomy usage has generally declined as less invasive options, like endometrial
ablation for symptomatic uterine bleeding and uterine artery embolization for uterine
leiomyomas, continue to gain popularity. Still, for many patients, a hysterectomy is
the best course of action.
The use of the abdominal approach to hysterectomy has frequently been attributed
to large uterine size. This is because it is believed that an enlarged uterus may
necessitate better visualization and exposure due to higher risks of blood loss,
damage to surrounding viscera, and longer operating periods. There are no set
guidelines regarding the size or weight of the uterus that would qualify a patient for
an abdominal hysterectomy, while research has indicated that less invasive methods
like laparoscopy can safely remove larger uteri.
BODY
Research indicates that when performed when clinically warranted, hysterectomy is
linked to a noteworthy enhancement in numerous quality of life metrics. Despite its
greater risk of morbidity and death, longer recovery periods and hospital stays, and
overall higher complication rates, abdominal hysterectomy is nevertheless a
regularly performed hysterectomy technique. Data on the long-term results of
randomized controlled trials contrasting hysterectomy with surgery are scarce.
Moreover, there is disagreement over the indications for hysterectomy approach.
The patient and the surgeon, in accordance with their respective areas of expertise,
should jointly make the final decision.
Even if more traditional abdominal surgeries are being replaced by endoscopic
methods, the next generation of surgeons still needs to become proficient in the
technical aspects of the traditional abdominal hysterectomy. A essential technique for
gynecologic oncologists and gynecologists managing benign gynecologic disease,
which typically necessitates open surgery, is an abdominal hysterectomy. This
process is also crucial for less invasive procedures requiring conversion to a
laparotomy.
It should be recognized that an abdominal hysterectomy is a serious procedure that
can have a profound effect on a woman's emotional and physical health. The
surgeon must assist patients in overcoming the emotional upheaval that may follow a
hysterectomy. During preoperative counseling, the doctor should ask open-ended
questions and make brief comments to the patient about how they are feeling in
order to support them and address any worry or emotional distress.
CONCLUSION
The most common major non-pregnancy-related surgery done on women in the US is a
hysterectomy. The uterus, cervix, and, in certain cases, the fallopian tubes and ovaries are
removed during this surgical surgery.
Treatment of uterine cancer and other frequent noncancerous uterine problems, such as
fibroids, endometriosis, prolapse, etc., which cause incapacitating levels of pain, discomfort,
uterine bleeding, and psychological stress, are the reasons behind this operation's decision.
While this technique is quite effective in treating the condition under consideration, it is a
surgical alternative that carries the risks, morbidity, and mortality associated with surgery,
and it causes sterility in premenopausal women. The patient might need to stay in the
hospital for a few days and recuperate for six to twelve weeks.
The most common gynecologic procedure is a hysterectomy, which is carried out for a
variety of benign disorders as well as malignant diseases, including fibroids, endometrial
hyperplasia, adenomyosis, uterine prolapse, dysfunctional uterine hemorrhage, and cervical
intraepithelial neoplasia. Hysterectomy for benign disease can be performed in a variety of
ways: abdominohysterectomy, vaginal hysterectomy, total laparoscopic hysterectomy (TLH),
where the uterine artery ligation is included in the laparoscopic procedures, vaginal
hysterectomy, laparoscopic assisted vaginal hysterectomy (LAVH), and subtotal
laparoscopic hysterectomy (STLH), in which the uterine body is removed using a morcelator
and no vaginal component. Many novel methods to preserve the uterus instead of requiring
a hysterectomy have been discovered in recent decades. They employ cutting-edge
technology, and their outcomes are encouraging and frequently on par with hysterectomy.
This study reviews all of the hysterectomy techniques currently in use as well as alternative
procedures for benign causes.
REFERENCES
Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M, Napp V, Bridgman S,
Gray J, Lilford R. EVALUATE hysterectomy trial: a multicentre randomised trial
comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health
Technol Assess. 2004 Jun;8(26):1-154. [PubMed]
