In gynecology, operations are performed through the vagina or by opening the abdominal cavity (cutting the skin), otherwise known as laparotomy. Depending on the scope of the operation, the opening of the abdominal cavity is performed through a longitudinal midline or transverse (suprapubic) cut, which is not always possible to apply. A straight cut is necessary, for example, if an organ tumor is suspected, severe obesity or giant fibroids. Removal of the uterus by the abdominal route The indications for the removal of the uterus by laparotomy include:

• chronic pelvic pain caused by endometriosis,
• chronic inflammation in the pelvic area,
• presence of uterine fibroids with vaginal bleeding,
• occurrence of benign changes in the uterus after the menopause.

The hysterectomy is sometimes combined (in justified cases) with the removal of the so-called appendages, that is, the ovaries and fallopian tubes and the surrounding tissues. Their removal prevents them from arising ovarian tumors and scar tissue (adhesions) that are the cause of these chronic pelvic pain. Usually an absorbable intradermal suture is used for suturing the skin.

Radical removal of the uterus along with the appendages that produce female sex hormones, estrogens and progesterone is used in the presence of cervical cancer, ovarian cancer, and endometrial cancer. After the surgery, it is necessary to introduce hormone replacement therapy in the patient.

The operation is preceded by a consultation visit at the Gynecological Clinic. Before the surgery a patient should make the following research:

• blood group,
• complete morphology with smear,
• general urine examination, coagulogram,
• ECG – after 40 years of age,
• electrolyte level,
• ionogram,
• HBS antigen,
• anti HCV,
• sugar level.