Your surgeon may need to change from a vaginal to an abdominal hysterectomy, after your operation has started. Your surgeon may be having difficulty separating your uterus from the tissues and organs surrounding it. There may be additional problems that your surgeon only sees after the surgery starts. Or there may be damage that occurs during surgery, such as to the intestine or bladder, that may be life-threatening or may require a larger incision to take care of.
If your surgeon changes from a vaginal to an abdominal hysterectomy, your incision will be longer, and it may take more time for you to recover.