Our Summary

This research examined the impact of two different types of hysterectomy operations - open field and laparoscopic - on the risk of wound infection and wound splitting open post-surgery. The study specifically focused on overweight patients. The researchers went through four major databases for studies conducted between 2000 and October 2023. They analysed the data using specific software and quality-checked all the included literature.

The study involved 874 cases, of which 387 underwent laparoscopic surgery and 487 had open surgery. The findings suggest that those who had laparoscopic surgery had a significantly lower risk of post-surgery wound infection compared to those who had open surgery. However, there was no significant difference in the risk of wounds splitting open after surgery between the two methods.

Additionally, the amount of blood loss during surgery was less in the laparoscopic group compared to the open surgery group. So, overall, for overweight women needing a hysterectomy, laparoscopic surgery could be a better option as it may lead to less blood loss during the operation and a lower risk of wound infection after surgery.

FAQs

  1. What is the difference in infection risk between open field and laparoscopic hysterectomy operations?
  2. Is there a difference in the risk of wounds splitting open after surgery between open field and laparoscopic hysterectomy operations?
  3. Does the type of hysterectomy operation affect the amount of blood loss during surgery?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about hysterectomy is to discuss the option of laparoscopic surgery with them, especially if they are overweight. This type of surgery may lead to less blood loss during the operation and a lower risk of post-surgery wound infection compared to open surgery. It is important for patients to have a thorough discussion with their healthcare provider about the different surgical options available and which one may be best for their individual situation.

Suitable For

Patients who are recommended hysterectomy include those with:

  • Uterine fibroids causing symptoms such as heavy menstrual bleeding, pelvic pain, and pressure
  • Endometriosis
  • Uterine prolapse
  • Abnormal uterine bleeding
  • Chronic pelvic pain
  • Gynecologic cancers such as cervical, ovarian, or uterine cancer

It is important for patients to discuss their individual medical history and symptoms with their healthcare provider to determine if a hysterectomy is the best treatment option for their condition.

Timeline

Before hysterectomy:

  1. Patient consults with a healthcare provider to discuss symptoms and treatment options.
  2. Patient undergoes various diagnostic tests such as ultrasound, MRI, or biopsy to determine the need for hysterectomy.
  3. Patient and healthcare provider discuss the risks and benefits of hysterectomy and decide on the best approach (open surgery, laparoscopic surgery, robotic-assisted surgery).
  4. Patient may undergo pre-operative tests such as blood work and imaging to ensure they are healthy enough for surgery.
  5. Patient is given instructions on pre-operative care including fasting guidelines and medications to avoid.

After hysterectomy:

  1. Patient undergoes surgery and is monitored in the recovery room before being transferred to a hospital room.
  2. Patient may experience pain, discomfort, and fatigue in the immediate post-operative period.
  3. Patient is given pain medications and instructions on post-operative care including wound care, activity restrictions, and follow-up appointments.
  4. Patient may stay in the hospital for a few days for monitoring and recovery, or may be discharged home the same day depending on the type of surgery.
  5. Patient may experience vaginal bleeding, discharge, and changes in bowel or bladder function in the weeks following surgery.
  6. Patient gradually resumes normal activities and may need to take time off work for recovery.
  7. Patient attends follow-up appointments with their healthcare provider to monitor healing and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy include:

  1. What type of hysterectomy procedure do you recommend for me and why?
  2. What are the potential risks and complications associated with the recommended procedure?
  3. How long is the recovery period expected to be and what can I do to help speed up the recovery process?
  4. Will I need to stay in the hospital after the surgery, and if so, for how long?
  5. What are the potential long-term effects of having a hysterectomy?
  6. Are there any alternative treatments or procedures that I should consider before opting for a hysterectomy?
  7. Will I experience menopause symptoms after the surgery, and if so, how can they be managed?
  8. How will a hysterectomy affect my sexual function and relationships?
  9. What can I do to prepare for the surgery and improve my chances of a successful outcome?
  10. Are there any specific lifestyle changes or precautions I should take after the surgery to ensure a smooth recovery process?

Reference

Authors: Long L, He X, Liu Y, Lei C. Journal: Int Wound J. 2024 Mar;21(3):e14664. doi: 10.1111/iwj.14664. PMID: 38439170