Total Hysterectomy with BSO

Hysterectomy and oophorectomy are female to male surgical procedures to help reduce gender dysphoria. There are four available techniques.
‍
1.  Laparoscopic Procedure
As opposed to a big incision, the surgeon will only make tiny incisions to allow thin instruments to enter the abdomen. This type of procedure helps reduce pain, scarring, blood loss, recovery time, and hospital stay as compared to open surgery. 
‍
2. Open Procedure or Abdominal Hysterectomy plus Bilateral Salpingo-Oophorectomy (BSO)
In this surgery, the surgeon makes a transverse incision on the abdominal wall, on top of the pubic bone and as close to the hairline of the patient’s lower pelvis as possible. The incision is similar to the incision used during a cesarean section and is approximately 4-5 cm long. This procedure gives the surgeon the best access to the reproductive structures which helps in the total removal of the reproductive complex. This is the most common hysterectomy technique and recovery time is between 4-6 weeks. 
‍
3. The Vaginal or V Procedure
The Vaginal or V technique is done entirely through the vaginal canal. This has advantages over open abdominal surgery like fewer complications, a shorter hospital stay, and faster healing time.

4. Natural Orifice Transluminal Endoscopic Hysterectomy with BSO and Oophorectomy or NOTE technique

This new technique removes the uterus and the ovaries and it is a combination of the two Transvaginal and Laparoscopic hysterectomy techniques. In this procedure, the surgeon inserts vaginal speculum into the vagina which is followed by a shield to help protect the cervix. 

After that, the surgeon will insert the surgical instruments into the vagina. Once dissected, the uterus along with the ovaries are removed through the vaginal opening.

‍