5 Total abdominal hysterectomy

Total abdominal hysterectomy will be performed on one of every three women in the USA. While few changes have occurred in modern times, operative laparoscopy is being used for hysterectomy, though its true role remains unclear. This chapter reviews the indications, preparation and common complications related to total abdominal hysterectomy. A detailed description of abdominal hysterectomy as it is performed at the Mayo Clinic is presented. Key features are pointed out, and the need for proper surgical technique is stressed; specifically, the proper dissection of ureter, bladder and rectum are reviewed and emphasis placed on the need for every pelvic surgeon to possess the skills required for performing these.