Hysterectomy is the most common gynecologic operation and the second most common major surgical procedure in the USA. The frequency of abdominal hysterectomy is 1 per 1000 in women younger than 25 years, but rises to 16 per 1000 in women older than 35 years. After the age of 35 years, women usually have completed their childbearing and also have a higher incidence of significant gynecologic disease. The mortality risk for hysterectomy in the USA has been studied by the Centers for Disease Control and Prevention, which reported 477 deaths among 317 389 women having abdominal hysterectomies from 1979 through 1980. The mortality rate for hysterectomy was higher for procedures associated with pregnancy and cancer than for procedures not associated with these conditions (29.2, 37.8, and 6.0 per 10 000 hysterectomies, respectively). Abdominal hysterectomy had a higher mortality rate than did vaginal hysterectomy. Excluding cases related to pregnancy or cancer, the mortality rate was 8.6 per 10 000 women for abdominal hysterectomy and 2.7 per 10 000 women for vaginal hysterectomy.

Simple total abdominal hysterectomy involves the removal of the uterine corpus and cervix through an abdominal incision and is performed for a variety of indications, including uterine leiomyomas, pelvic abscesses, endometriosis, and recurrent dysfunctional uterine bleeding. In addition, simple abdominal hysterectomy is performed for two malignant indications: adenocarcinoma of the endometrium and ovarian cancer. Invasive cancer of the cervix requires a radical abdominal hysterectomy.