Hysterectomy Options

 Hysterectomy Options

Physicians perform hysterectomy - the surgical removal of the uterus - to treat a wide variety of uterine conditions. Each year in the U.S. alone, doctors perform approximately 600,000 hysterectomies, making it the second most common surgical procedure for women.

Types of Hysterectomy

There are various types of hysterectomy that are performed depending on the patient's diagnosis. All hysterectomies involve removal of the uterus. What can vary are which additional reproductive organs and other tissues that may be removed. Types of hysterectomy include:

·      Partial or subtotal hysterectomy

·      Total hysterectomy

·      Removal of lymph nodes

·      Removal of the fallopian tubes and ovaries

·      Radical hysterectomy

·      Total hysterectomy

Approaches to Hysterectomy

Surgeons perform the majority of hysterectomies using an "open" approach, which is through a large abdominal incision. An open approach to the hysterectomy procedure requires a 6-12 inch incision.

A second approach is vaginal hysterectomy, which involves the removal of the uterus through the vagina, without any external incision or subsequent scarring. Surgeons most often use this minimally invasive approach if the patient's condition is benign, when the uterus is normal size and the condition is limited to the uterus.

In laparoscopic hysterectomies, the uterus is removed using instruments inserted through small tubes into the abdomen, resulting in 3-5 small incisions in the abdomen. One of these instruments is an endoscope - a small miniaturized camera - which allows the surgeon to see the target anatomy on a standard 2D video monitor. A laparoscopic approach offers surgeons better visualization of affected structures than either vaginal or abdominal hysterectomy.

You may encounter shorthand abbreviations describing different approaches to hysterectomy. Some of these are as follows:

·      Total Laparoscopic Hysterectomy (TLH)

·      Laparoscopic Supracervical Hysterectomy (LSH)

·      Total Vaginal Hysterectomy (TVH)

·      Total Abdominal Hysterectomy (TAH)

While minimally invasive vaginal and laparoscopic hysterectomies offer important potential advantages to patients over open abdominal hysterectomy - including reduced risk for complications, a shorter hospitalization and faster recovery - there are inherent drawbacks. With vaginal hysterectomy, surgeons are challenged by a small working space and lack of view to the pelvic organs. Additional conditions can make the vaginal approach difficult, including when the patient has:

·      A narrow pubic arch (an area between the hip bones where they come together)

·      Thick adhesions due to prior pelvic surgery, such as C-section

·      Severe endometriosis

·      Non-localized cancer (cancer outside the uterus) requiring more extensive tissue removal, including lymph nodes

With laparoscopic hysterectomies, surgeons may be limited in their dexterity (since the instruments are straight and rigid) and by 2D visualization, both of which can potentially reduce the surgeon's precision and control when compared with traditional abdominal surgery.

da Vinci Hysterectomy

One in three women in the U.S. will have a hysterectomy before she turns 60. While no woman wants to face surgery, today the vast majority of gynecologic conditions - from endometriosis to uterine fibroids, heavy menstrual bleeding to cancer - can now be treated effectively without a big incision. With da Vinci^® Surgery, a hysterectomy requires only a few small incisions, so you can get back to life faster - within days rather than the usual weeks required with traditional surgery.

da Vinci Surgery enables gynecologists to perform the most precise, minimally invasive hysterectomy available today. For most women, da Vinci Hysterectomy offers numerous potential benefits over traditional open surgery, including:

·      Significantly less pain

·      Minimal blood loss and need for transfusion

·      Fewer complications

·      Shorter hospital stay

·      Quicker recovery and return to normal activities

·      Small incisions for minimal scarring

·      Better outcomes and patient satisfaction, in many cases

Surpassing the limits of conventional laparoscopic surgery, da Vinci is revolutionizing gynecologic surgery for women. No wonder more and more women are choosing da Vinci Surgery for their hysterectomy.

If you have been putting off surgery to resolve a gynecologic problem, it may be time to ask your doctor about da Vinci Surgery.