- Total Hysterectomy
- Bilateral Salpingo
- + /- Pelvic Lymph Node Dissection
Please refer to the section on hysterectomy as well.
Cancer that starts in the uterus can spread to lymph nodes in the pelvis (lymph nodes are pea-sized collections of immune system tissue). To check for lymph node spread, your surgeon might remove some of these lymph nodes. This procedure is known as a lymph node dissection or lymph node sampling.
There are some risks of surgery for endometrial cancer and specifically for a hysterectomy;
- Laparoscopic surgery may need to be converted to open surgery through the opening of the abdomen. The vast majority of all laparoscopic procedures will be completed laparoscopically
- There is a risk of injury to pelvic organs, such as the bowel, the bladder, the ureters, blood vessels and nerves (~1.5%). These injuries usually are repaired during surgery. In an exceedingly small proportion of patients these injuries can unfortunately are not recognised during surgery or injuries may even develop after surgery
Injury to big blood vessels may result in bleeding and the need of blood transfusion. Injury of nerves is common in patients who require removal of lymph nodes in the pelvis. In that case, patients will experience some numbness of the skin around the upper thigh
- The risk of a bleed to the vagina is approximately 4%. A bleed can be triggered by an infection and may develop into a haematoma (clot collection). In the majority of patients, a course of antibiotics will solve the problem
- Lymph oedema – Lymphatic fluid usually drains from the legs via the lymph glands in the pelvis and into the blood circulation. When lymph glands have to be removed, some fluid may accumulate in the legs (lymph oedema). The risk of lymph oedema is around 15% in patients who had to have a lymph node dissection
- Infections to the bladder, the abdominal wound, the lungs
- Thromboembolic complications (formation of blood clots) in the legs that can even travel to the lungs and cause life-threatening emboli. This risk is very small (less than 1%) because of our efforts to minimize them
Other possible issues include;
- Shoulder tip pain is common after laparoscopic surgery. It is caused by the CO2 gas that s needed for the surgery. It normally lasts for a day or two but painkillers are not that effective
- After hysterectomy a vaginal discharge which can be blood-stained may occur for up to 6 weeks