Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice

Hysterectomy in one minute

What it is: surgery to remove the womb (uterus), sometimes with the cervix, fallopian tubes and ovaries.

Who it is for: people with heavy bleeding, fibroids, prolapse, endometriosis or cancer, when other treatments are not suitable.

Main risks: bleeding, infection, injury to bladder, ureter or bowel, blood clots.

Usually: under general anaesthetic, 1–3 hours, home in 1–5 days.

On this page: What is a hysterectomy? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ

Diagram of the womb with fallopian tubes and ovaries, with the womb outlined

What is a hysterectomy?

A hysterectomy removes the womb. Afterwards there are no periods and pregnancy is not possible. There are several types:

total: womb and cervix removed; subtotal: cervix left in place
with or without the tubes (salpingectomy) and ovaries (oophorectomy)
radical: for some cancers, with nearby tissue and lymph nodes

The route can be laparoscopic (keyhole), abdominal (open), or vaginal, per surgeon. If the ovaries are removed before menopause, menopause starts straight away.

New to the acronyms? See the Cath Lab Abbreviations A–Z.

Who is it for?

It may be considered for people with:

heavy menstrual bleeding not helped by other treatments
fibroids
pelvic organ prolapse (often vaginal hysterectomy)
endometriosis or adenomyosis
cancer of the womb, cervix or ovaries

The decision is made by your surgical team, who will talk through the reasons, the alternatives and the risks with you.

When is it done?

Most operations are planned; some are urgent. Before it, you usually have:

an examination, and usually an ultrasound scan
blood tests, including blood count and group and save
a pregnancy test where relevant
a review of your medicines, especially blood thinners, as per centre protocol
a chance to ask questions and give consent

Timeline of the usual steps before hysterectomy: Clinic: Assessment and consent, Pre-assessment: Bloods, medicines, On the day: Checks, WHO sign in, In theatre: About 1–3 hours

Step by step

1. Getting ready

Team brief and WHO checklist first. The anaesthetic team and ODP give a general anaesthetic and insert a breathing tube; antibiotics and blood-clot prevention are given as per centre protocol. The circulating practitioner checks positioning, pressure areas, the diathermy plate, warming, and that the camera stack and gas insufflator work. The scrub practitioner sets up the laparoscopic trolley and an open set in case of conversion, and does the first count. The patient is placed in lithotomy (legs in supports) with careful padding; a urinary catheter and a uterine manipulator may be placed, per surgeon.

2. Access

Laparoscopic: ports at the belly button and lower abdomen. Abdominal: a low horizontal or a vertical cut. Vaginal: no abdominal cut.

Front view of a patient showing a belly button port and two lower abdominal port sites

3. Removing the womb

A. Ligaments divided. The ligaments supporting the womb are sealed and divided.
B. Vessels sealed. The uterine blood vessels are sealed, with the ureters kept safe.
C. Womb removed. The womb is separated from the vagina and removed, through the vagina or a small cut.
D. Vault closed. The top of the vagina (vault) is closed with sutures.

Four-panel schematic of hysterectomy: ligaments divided, vessels sealed, womb removed, vault closed

4. Finishing

The gas is let out, ports removed and the larger cuts closed (deep layer, per surgeon), then the skin with sutures or glue. Local anaesthetic is often injected into the wounds. Final counts are confirmed, specimens labelled and checked, and the patient goes to recovery with a full handover.

Recovery and aftercare

First hours: in recovery, then a ward or day unit; pain relief and anti-sickness medicine.
Going home: often 1–2 days after keyhole or vaginal surgery, 3–5 days after open surgery.
Activity: walking early; avoid heavy lifting for about 6 weeks; ask your team.
Bleeding: some vaginal bleeding or discharge is common for a short time.
Sex and driving: ask your team when it is safe.
Follow-up: results and review, as per centre protocol.

Call 999 if you have heavy bleeding, severe pain, breathlessness, chest pain or collapse. Contact your team or GP if you have a fever, smelly discharge, pain or swelling in a leg, or a wound that becomes red, hot or leaky.

Risks and complications

Your team will explain the risks that apply to you. Possible problems include:

bleeding, sometimes needing transfusion
wound, pelvic or urine infection
injury to the bladder, ureter or bowel (uncommon)
blood clots in the legs or lungs
early menopause if the ovaries are removed
vault problems or prolapse later (rare)
conversion from keyhole to open surgery

Theatre kit list (printable)

Example kit list

Every theatre has its own protocol, and sizes and doses vary.

laparoscopic stack: camera, scope, light source, gas insufflator and warmer
ports, sizes per device and operator, and an entry needle or open-entry kit, per surgeon
laparoscopic graspers, scissors, dissectors and suction-irrigation
energy device, per surgeon
uterine manipulator, per surgeon
lithotomy supports and padding
vaginal instruments and retractors for vaginal route
specimen retrieval bag or morcellation system, as per centre protocol
vault closure sutures
urinary catheter and dressings

Generic drawings of the main kit: camera scope, port, energy device, fine suture

Procedural steps

Team brief, WHO sign in; anaesthesia; antibiotics and clot prevention as per centre protocol
Lithotomy; padding; catheter; manipulator; prep and drape; count
Ports or incision; inspection
Ligaments and vessels sealed and divided; ureters protected
Womb removed; vault closed
Haemostasis; closure; counts; specimen check; sign out and handover

Recovery timeline after hysterectomy: Day 0: Recovery, pain relief, Days 1–5: Home for most, 6 weeks: No heavy lifting, 6–8 weeks: Review, results

First time in theatre?

💡 First-time tip

Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.

Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.

Specimens. Label every specimen with site and side, and check it with the scrub practitioner before it leaves theatre.

Lithotomy safety. Raise and lower both legs together; check padding to protect nerves.

Open set ready. An open tray stays available in case of conversion.

FAQ

Will I go through menopause?

Only if the ovaries are removed before menopause.

Can I still have sex?

Yes, after healing; ask your team when.

Will I need smear tests?

It depends on the type; your team will advise.

Sources

All checked on 14 October 2026. Each page's own date is shown where it gives one.

NHS. Hysterectomy. nhs.uk/conditions/hysterectomy
NICE. Heavy menstrual bleeding: assessment and management (NG88). nice.org.uk/guidance/ng88
StatPearls (NCBI Bookshelf), search: hysterectomy. ncbi.nlm.nih.gov/books
World Health Organization. Surgical Safety Checklist. who.int

Disclaimer

Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.

Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.

All diagrams on this page are original illustrations created for rodnieoro.com.

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Oct 14 Hysterectomy: an OR 101 guide

What is a hysterectomy?

Who is it for?

When is it done?