Chairman

Institute of Minimal Access, Metabolic & Bariatric Surgery (iMAS) Sir Ganga Ram Hospital | New Delhi

Medical Director

Bhatia Global Hospital & Endosurgery InstitutePaschim Vihar | New Delhi
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News & Highlights

Understanding Hairfall post Weight Loss surgery 26-May-2017

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Why Protein First 10-May-2017

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Media & Press Coverage

Surgery on the rise for obese teens. 25-Aug-2013 \"If the child is showing comorbidities like diabetes and hypertension, has reached puberty and achieved certain growth milestones then su

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Obesity prompts more cases of bariatric surgeries. 28-Jul-2013 \"By 2020 we will become the diabetic capital of the world. Its alarming.\" says Dr. Parveen Bhatia, Chairman of iMAS at Sir Ganga Ram H

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Hysterectomy

 What is a Hysterectomy? 


A hysterectomy is the surgical removal of the uterus. The uterus is a muscular, pear-shaped organ that is part of the female reproductive system. Sometimes, your doctor may also recommend removal of the ovaries where eggs are formed, and the fallopian tubes which the eggs travel through to get to the uterus during a woman’s child bearing years.

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There are Four different ways to perform a hysterectomy: 


1. Standard Abdominal Hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks.

2. Vaginal Hysterectomy can be done entirely through the vagina, or using a laparoscope (Laparoscopic-Assisted Vaginal Hysterectomy, or LAVH). Only women with a relatively small fibroid, small uterus, and no previous caesarean sections can have this. Approximate recovery time: Two weeks.

3. Total Laparoscopic Hysterectomy involves only small “keyhole” incisions, often made in the navel or abdomen. Approximate recovery time: Two weeks or less.

Port Position in TLH

4. Robotic-Assisted Total Laparoscopic Hysterectomy Using a state-of-the art robotic platform allows the surgeon a full view of the surrounding organs and more precise control over incisions. 

Hysterectomy Table

Reasons for Hysterectomy

Hysterectomy is also used to treat uterine and cervical cancer. 


Removal of Ovaries


Depending on your medical diagnosis, ovaries may not be  removed. The removal of your ovaries may lead to symptoms associated with menopause, including hot flashes, insomnia, irritability, or vaginal dryness. These symptoms may be reduced by alternative therapies. 

Removal of Ovaries


Removal of lymph nodes


For hysterectomies performed for malignant conditions – such as uterine, cervical, or ovarian cancer – the surgeon will also remove certain lymph nodes. This procedure is often referred to as a lymph node dissection or lymphadenectomy. Lymph nodes will be removed in certain areas, depending upon the location and extent of the disease. Lymph node removal also helps your surgeon determine the extent or stage of your cancer, and can guide further adjuvant treatment, such as radiation therapy or chemotherapy. 

Removal of Lymph Nodes


Benefits of Laparoscopic hysterectomy


• Less Time in the Hospital

Laparoscopic hysterectomies require less time in the hospital compared to abdominal hysterectomy. Most patients can expect to go home the same day as surgery or within 24 hours, whereas abdominal hysterectomies usually require 5-6 days in the hospital.

• Quicker Recovery  

With laparoscopic hysterectomy, many patients return to normal activity within a few weeks. Abdominal hysterectomy patients can expect up to 6 weeks or more of recovery.

• Less Pain & Scarring  

Laparoscopic hysterectomy procedures only require a few small incisions, which means less postoperative pain compared to abdominal hysterectomy. The smaller incisions also result in less scarring on the abdomen. 

Screen Shot 2013-07-01 at 2.46.57 AMUterus with Cervix Removed


Risks & Complications


Before making your decision to have surgery, it is important to understand the risks. There is always a probability that your laparoscopic hysterectomy may be converted to an open procedure if there are unforeseen complications during your procedure such as difficult anatomy or excessive bleeding. While major risks are rare, all surgery should be considered carefully. With laparoscopic surgery, as with all surgery, there are the typical risks of reactions to medications or problems resulting from the anesthesia, bleeding, infection, problems breathing, blood clots in the veins or lungs, inadvertent injury to other organs or blood vessels near the uterus, and even death, which is rare. The risk for serious complications depends on the reason the surgery is needed and your medical condition and age, as well as on the experience of the surgeon and anesthesiologist. 

Multiple FibroidLap Myomectomy


What to expect after a laparoscopic hysterectomy?


In most instances you will be admitted to hospital on the day of your operation. You may be able to go home within 48 hours or, depending on your circumstances, you may need to stay in hospital for 1 to 3 days.

After-effects of General Anaesthesia

Most modern anaesthetics are short-lasting. During the first 24 hours you may feel more sleepy than usual and your judgement may be impaired.

Scars

You will have between 3 or 4 small scars on different parts of your tummy. Each scar will be between 0.5 cm and 1 cm long. You will also have a scar at the top of your vagina which will be out of sight.

Stitches and dressings

Your cuts will be closed by stitches. These stitches dissolve by themselves. Initially, your cuts will be covered with a dressing.

You should be able to take this off about 24 hours after your operation and have a wash or shower. Any stitches in your vagina will not need to be removed as they are dissolvable.

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Catheter

You may have a catheter (tube) in your bladder to allow drainage of your urine. Thisis usually for up to 24 hours after your operation until you are easily able to walk to the toilet to empty your bladder.

Packs

You may have a pack (a length of gauze like a large tampon) in your vagina after the operation to reduce the risk of bleeding. This will be removed by your doctor after your operation while you are still in hospital.

Vaginal bleeding

You can expect to have some vaginal bleeding for 1 to 2 weeks after your operation. This is like a light period and is red or brown in colour. Some women have little or no bleeding initially and have a sudden gush of old blood or fluid about 10 days later. This usually stops quickly. You should use sanitary napkins if required. 

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Pain and discomfort

You can expect pain and discomfort in your lower tummy for at least the first few days after your operation. You may also have some pain in your shoulder. This is a common side-effect of laparoscopic surgery. When leaving hospital, you will be provided with painkillers for the pain you are experiencing.

Starting to eat and drink

After your operation you may have a drip in your arm to provide you with fluids. When you are able to drink again the drip will be removed. You will be offered a drink of water or cup of tea and something light to eat.

Washing and showering

You should be able to have a shower or bath and remove any dressings the day after your operation. Keeping scars clean and dry helps healing.

What can help me recover?

There are a number of positive steps you can take at this time. 

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Getting back to normal

While it is important to take enough rest, you should start some of your normal daily activities when you get home and build up slowly. You will find you are able to do more as the days and weeks pass.

It is helpful to break jobs up into smaller parts and taking rests regularly. You can also try sitting down while preparing food or sorting laundry. For the first 1 to 2 weeks you should restrict lifting to light loads such as a 1 litre bottle of water.You should not lift heavy objects or do any strenuous house work.

Avoid squatting position while doing Puja or using Indian style toilets.