A partial hysterectomy, also called a supracervical hysterectomy, removes the main body of the uterus while leaving the cervix in place. The surgery can be performed through a large abdominal incision, through several small incisions using a camera and long instruments, or with robotic assistance. The approach your surgeon chooses depends on the size of your uterus, the reason for surgery, and your overall health. Here’s what actually happens before, during, and after the procedure.
What Gets Removed and What Stays
In a partial hysterectomy, the surgeon detaches and removes the body of the uterus but leaves the cervix (the lower neck of the womb) intact. This differs from a total hysterectomy, which removes both the uterus and the cervix. In either case, the ovaries are typically left in place unless there’s a specific reason to remove them, such as a high cancer risk or ovarian disease. Keeping the ovaries means your body continues producing hormones naturally, so you won’t be thrown into surgical menopause.
Preparing for Surgery
In the days before your procedure, your surgical team will give you specific instructions about when to stop eating and drinking. These fasting windows are strict: if you eat or drink past the cutoff, the surgery may be cancelled because anesthesia is safer on an empty stomach. On the day of surgery, you’ll shower or bathe but skip lotions, perfumes, deodorants, and nail polish. Don’t shave the surgical area yourself. If you take daily medications, your doctor will tell you which ones to take that morning with just a small sip of water.
The Open Abdominal Approach
An open partial hysterectomy uses a single incision in the lower abdomen. Your surgeon will make either a horizontal cut about an inch above the pubic bone (sometimes called a bikini-line incision) or a vertical cut running from below the navel down toward the pubic bone. The horizontal incision follows the skin’s natural crease lines and generally leaves a thinner scar. The vertical incision gives the surgeon more room to work and is more common when the uterus is very large or when additional procedures are planned at the same time.
Once inside, the surgeon separates the uterus from its blood supply, disconnects it from the ligaments that hold it in place, and cuts it free from the cervix. The cervical stump is then closed, the surgical site is checked for bleeding, and the incision is stitched shut in layers. This approach requires the longest recovery because it cuts through the full abdominal wall.
The Laparoscopic Approach
Laparoscopic surgery accomplishes the same thing through much smaller openings. The surgeon begins by making a small incision near the belly button and inserting a narrow tube called a trocar. Carbon dioxide gas is pumped into the abdomen to inflate it, creating space between the organs so the surgeon can see and work safely. The target pressure is kept as low as effective to reduce side effects like shoulder pain from the gas.
Two or three additional small incisions are made on either side of the lower abdomen for the camera and surgical instruments. The surgeon first surveys the pelvis, identifies the ureters (the tubes running from kidneys to bladder) to avoid injuring them, and then begins working through the structures that anchor the uterus. The fallopian tubes are often removed at the same time. The round ligaments, blood vessels supplying the uterus, and the broad ligament are each sealed with an energy device and cut, working systematically from the outer attachments inward.
When the uterus is freed from the cervix, it needs to come out through one of those small incisions. If the uterus is too large to fit, the surgeon uses a process called morcellation, cutting the tissue into smaller pieces inside a containment bag. The FDA recommends that power morcellation only be done inside a tissue containment system to prevent any unseen abnormal cells from scattering into the abdomen. Power morcellation is not used when cancer is known or suspected, or in women who are postmenopausal or over 50, who are better candidates for removing the tissue in one piece through the vagina or a slightly larger incision.
Robotic-Assisted Surgery
Robotic surgery follows the same basic sequence as laparoscopic surgery, but the surgeon controls the instruments from a computer console in the operating room rather than standing directly over you. A high-definition 3D camera provides a magnified view of the surgical field, and the robotic arms translate the surgeon’s hand movements into extremely precise motions at the instrument tips. The arms can rotate and bend in ways that human wrists cannot, which helps in tight spaces. An assistant stands at the operating table to reposition instruments or swap tools as needed. Recovery timelines are similar to standard laparoscopic surgery.
Why Some Surgeons Leave the Cervix
The decision to keep or remove the cervix involves tradeoffs. Leaving the cervix in place preserves a cluster of nerves called the uterine cervical ganglia that pass near it. These nerves play a role in internal orgasm. Research from Kilkku and colleagues found that women who kept their cervix reported no loss in sexual function, while women who had the cervix removed were more likely to report sexual difficulties afterward. Internal orgasms in particular tend to change after any hysterectomy because the uterine muscles that contract during orgasm are gone, but retaining the cervix and its surrounding nerve pathways appears to protect sensation more effectively.
The downside of keeping the cervix is that you still need regular cervical cancer screenings (Pap smears), and a small amount of uterine lining can remain in the cervical stump. About 4% of women who undergo a laparoscopic partial hysterectomy experience light cyclic bleeding afterward, essentially mini-periods, though the amount is minimal.
Recovery Timeline by Approach
How quickly you bounce back depends heavily on which surgical method was used.
- Open abdominal: Most women go home 2 to 3 days after surgery. Full recovery takes 6 to 8 weeks, after which you can resume exercise and sex.
- Laparoscopic: Most people feel noticeably better within 2 to 3 weeks. Walking early and often helps recovery, but heavy lifting and intense exercise should wait.
- Robotic-assisted: Full recovery generally takes 3 to 4 weeks. The same restrictions on lifting and sex apply during that window.
Across all approaches, the standard rule is no lifting anything heavier than 10 pounds for 6 weeks. That includes laundry baskets, grocery bags, children, and pets. You should also avoid vacuuming, pushing heavy doors, or pulling loaded grocery carts during that time. Most women can return to desk work whenever they feel ready, as long as the lifting restriction is respected.
What to Expect After Surgery
Some vaginal spotting or light discharge is normal in the first few weeks. Because a small amount of uterine lining can persist in the cervical stump, you may notice very light bleeding around the time your period would have occurred. This can continue for up to a year but is typically so minor it only requires a panty liner, if anything.
Your ovaries, if preserved, continue producing estrogen and progesterone on their usual cycle. You won’t go through menopause from the surgery itself, and you shouldn’t experience hot flashes or other hormonal symptoms as a direct result. Menopause will still happen naturally at whatever age it would have occurred otherwise. You will no longer be able to become pregnant, since the uterus is gone, but your hormonal rhythm continues behind the scenes until your ovaries wind down on their own schedule.