Feeling Better About Your Hysterectomy Choices


Choices

If you're like most women, you spend so much of your time taking care of others, you forget about your own health. That's why it's important to recognize the warning signs of common health conditions for women. It may be something small, like pressure in your stomach, or perhaps incontinence and constipation. Maybe even abnormal bleeding or soreness of the breasts.

Whatever symptoms you're having, early detection of a problem is always a good thing. If you're feeling any symptoms, and think you may have a women's health condition, it's important to talk with your doctor. Monthly breast exams and annual pap smears can help catch serious problems early, so you can do the most to prevent and treat them.

If you've seen your doctor, your doctor may have diagnosed you with:

  • Uterine Fibroids
  • Endometriosis
  • Uterine prolapse
  • Cancer – Breast cancer, ovarian cancer, uterine cancer, cervical cancer, or endometrial cancer
  • Abnormal uterine bleeding

Treatments for these various women's health conditions can range from changes in lifestyle and exercise to medication. Eventually, however, surgery may become necessary. If your doctor recommends surgery, it's important to know that you have options. Even if immediate surgery is needed, you should try to learn as much as you can about the approach your surgeon will use to treat you. In many cases, minimally invasive techniques are available, which offer unique advantages. These have been proven as effective as traditional "open" surgery, which requires a large incision.

In a minimally invasive procedure (MIP), sometimes referred to as a laparoscopic procedure, no large incisions are made. Instead, your surgeon makes several small incisions and performs the surgery using advanced devices and a specialized video camera called a laparoscope, which allows the surgeon to see inside your body. These procedures traditionally cause less pain and scarring after surgery and may promote faster recovery – so you can get back to life again, quicker and easier.


What is MIP

In 1988, Dr. J. Barry McKernan, after making only a 10mm incision, inserted a laparoscope (or miniature camera) into a patient’s abdomen and removed a gall bladder. The patient recovered in days, rather than weeks or months. This was the first laparoscopic cholecystectomy performed in the U.S. and the beginning of the minimally invasive movement in surgery.

Since then, minimally invasive procedures have been changing the way people think about surgery. Patients who choose these innovative procedures over conventional surgery usually have shorter hospital stays and quicker recovery. This means getting back sooner to the things that are important in life.
How Minimally Invasive Procedures Work

Minimally invasive procedures, which include laparoscopic surgery, use state-of-the-art technology to reduce the damage to human tissue when performing surgery. For example, in most procedures, a surgeon makes several small ¾ inch incisions and inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then a miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Then, specialized instruments are placed through the other trocars to perform the procedures. In some cases, such as minimally invasive colon surgery, a slightly larger incision may be needed. But with others, like minimally invasive hemorrhoid procedures, no incisions or trocars are necessary.

There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry – meaning only one small incision. This is called Single Site Laparoscopy, and is another approach to performing traditional laparoscopic surgery using the same tools.
Are you a candidate for a minimally invasive procedure?

These kinds of procedures are not for everyone and only your doctor can determine if a minimally invasive surgery is right for you. These procedures have been proven to be as effective as those of conventional surgery. And more than 20 million Americans have had them.
Benefits of minimally invasive procedures

Not only do these procedures usually provide equivalent outcomes to traditional "open" surgery (which sometimes require a large incision), but minimally invasive procedures (using small incisions) may offer significant benefits as well:

  • Quicker Recovery – Since a minimally invasive procedure requires smaller incisions than conventional surgery (usually about the diameter of a dime), your body may heal much faster.
  • Shorter Hospital Stays – Minimally invasive procedures help get you out of the hospital and back to your life sooner than conventional surgery.
  • Less scarring – Most incisions are so small that it's hard to even notice them after the incisions have healed.
  • Less pain – Because these procedures are less invasive than conventional surgery, there is typically less pain involved.


Hysterectomy Procedures

If you've recently been diagnosed with a health condition that requires the removal of your uterus (hysterectomy), you may now be searching for information about the different types of procedures. You should discuss the various options with your doctor. Ultimately, your surgeon will determine the type of hysterectomy you'll need, based on the specific circumstances of your condition. The four types of hysterectomy procedures are:

Partial or supracervical hysterectomy.

The cervix (lower end of the uterus) is left intact and only the upper part of the uterus is removed. Since the cervix is still there, there is a risk of cervical cancer, and regular pap screenings will still be required.


Complete or total hysterectomy.

This is the most common type of procedure, and involves the entire removal of the uterus, including the cervix.
Total hysterectomy and bilateral salpingo-oophorectomy. This is a total hysterectomy, plus the removal of the ovaries and fallopian tubes. As a result, the patient will go through what is known as surgical menopause. Ask your doctor about the best way to treat the symptoms of menopause.


Radical hysterectomy.

The removal of the cervix, the uterus, the upper part of the vagina, and supporting tissues, including the lymph nodes (usually performed when cervical cancer is involved).

Different ways to perform hysterectomy surgery

If your doctor has recommended a hysterectomy, it's important to get as much information about the procedure. How it's performed may provide certain advantages in the speed and ease of your recovery. For example, here are two methods for a hysterectomy:

During a traditional “open” surgery, a large incision is made to the abdomen in order to view the internal organs and remove the uterus.
With minimally invasive procedures, also called laparoscopic hysterectomies, surgeons use specialized tools inserted through smaller incisions. This approach typically results in less pain and scarring after the operation and may lead to a faster recovery.

Talk with your Doctor

If your doctor has recommended that you a have a hysterectomy, it can be overwhelming. So it is important to feel comfortable enough to ask any questions you have. You should get as much information as you can to help you understand the reasons why your uterus needs to be removed and all the possible outcomes. Here are some questions for you to get the conversation started.

  • Are there different types of hysterectomies?
  • How long will it take me to recover from having a hysterectomy?
  • When will I be able to leave the hospital?
  • Will my ovaries or any reproductive organs other than my uterus be removed?
  • When can I resume my normal activities, including school, work, exercise, sexual activity, and recreation?
  • What type of hysterectomy will I have? Is it a total abdominal hysterectomy or a minimally invasive procedure?
  • Is there a type of minimally invasive procedure appropriate for my situation?
  • Exactly where, and how big, will the incisions be that are made on my body to perform the surgery?
  • I'd like to make sure I am having the least-invasive procedure. Is that possible?


Risks


As with any surgical procedure, Minimally Invasive Procedures (MIP) for hysterectomy may present risks. Talk to your doctor about whether you are a candidate for MIP for hysterectomy. And remember, the risk for serious complications depends on  the reason the surgery is needed and your medical condition and age, as well as on the experience of the surgeon and anesthesiologist. Ask your doctor or surgeon about what to expect after surgery, as well as the risk that may occur with surgery, including those listed below:

Risks of any surgery

  • Reactions to medications or problems resulting from anesthesia
  • Problems breathing
  • Bleeding
  • Infection
  • Blood clots in the veins or lungs
  • Death (rare)
  • Inadvertent injury to the organs and vessels near the uterus

Rist of conventional surgery

  • Muscle injury
  • post-operative incisional hernia