What Would Cause My Surgeon to Convert My Hysterectomy?

Before choosing a minimally invasive hysterectomy, you and your surgeonprobably sat down and talked over your options. No matter how comfortable you were with your decision, reading the consent form may have given you pause. You were asked to sign that your minimally invasive surgery may need to be converted to an open abdominal procedure. It was scary enough already, now you have more questions.

What are the chances your surgeon will need to convert? What would cause your surgeon to need to make changes mid-surgery? Is there anything you can do to prevent them? Your mind is in a whirl with all the possibilities.

Good thing for you, your HysterSisters are here for you. They’ve had your same fears and some have even woke up to find their procedure had changed. Here’s what they have to share.

Adhesions

One of the big reasons your HysterSisters have had their hysterectomies converted is because extensive adhesions were found. The type of scar tissue can develop from previous surgeries, endometriosis, infection, or some other trauma, and their tangled webs can cement pelvic organs together. That can make it difficult for a surgeon. If you, too, are found to have extensive adhesions, your surgeon may need to convert to an open hysterectomy to be able to separate everything and safely remove your uterus.

Endometriosis

Another reason some of your HysterSisters have had their hysterectomies converted is because of unexpected endometriosis. Depending on the skill of the surgeon and the extensiveness of the implants, endometriosis may force your surgeon to switch from a minimally invasive hysterectomy to an open procedure so there’s enough room to work and clean up the endometriosis.

Unexpected or Larger Fibroids

Some of your HysterSisters have had fibroids hiding in their pelvis. Others had known fibroids, but they turned out to be bigger than expected during surgery. When this occurs, the surgeon may be forced to convert to a different hysterectomy type to be able to remove them.

Large Uterus

A reason some of your HysterSisters have been warned they could end up with a conversion is the size of the uterus. If the uterus is larger than expected, it may be impossible for the surgeon to remove it vaginally or through a smaller incision. The surgeon may find it necessary to convert to a different type of hysterectomy so the uterus can be removed in one piece. Uniquely, your size does not dictate whether or not your uterus will be enlarged.

No Vaginal Births

Those who haven’t given birth vaginally can be warned that while the surgeon may try to do the hysterectomy vaginally, it may need to be converted. One reason is that during pregnancy everything in the pelvic area stretches out a bit to accommodate a growing baby and delivery, and that stretching can make it helpful for the surgeon to be able to remove the uterus during a vaginal or vaginal assisted hysterectomy. In women who haven’t given birth vaginally, everything may be too tight and small, depending on her anatomy.

Complications

Besides finding things that were unexpected, sometimes things don’t go as planned during a hysterectomy. For some of your HysterSisters, when things went wrong the surgeon had to convert as a life saving measure. Some of the complications they’ve experienced include nicked bladder, cut ureter, nicked artery, damage from organs scarred together, fibroid involving other organs, unexpected cancer, and a high uterus.

Your Risks

It’s best to discuss your fears and concerns with your doctor prior to surgery. Whether or not your surgeon will need to convert your hysterectomy will depend on a number of factors. There’s no simple black and white, if this then that, scenario because there are too many variables involved, such as the experience and skill of your surgeon, type of hysterectomy being attempted, your specific circumstances, your diagnosis, any unexpected event, any imminent danger to your health, equipment available, anesthesia concerns, and more. Your surgeon should be able to share the possibilities and may even be able to put your mind at ease by explaining your specific risks.