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Small incisions make a big impact for fibroids and hysterectomies

May 16, 2019

Small incisions make a big impact for fibroids and hysterectomies

If the word “hysterectomy” reminds you of the stories your mother or grandmother told you about their experiences with this particular surgery, it’s time to reevaluate what you know (or think you know) about gynecological procedures. Today’s minimally invasive surgeries use advanced robotic laparoscopy to deliver a more effective treatment with less pain, quicker recovery, and lower risk of infection and other complications.

“Minimally invasive surgery replaces the need for large incisions,” explained Steven Crawford, MD, medical director of obstetrics and gynecology for Kettering Health Network’s Soin Medical Center. “Our advanced robotics surgical techniques use smaller incisions in the abdomen or pelvis, instead of opening larger ones. This allows us to do a variety of procedures, ranging from uterine polyp removal to treatment of tubal pregnancy.”

Most less-invasive surgeries fall under one of two types: hysterectomy or myomectomy.

A physician may suggest a hysterectomy to treat a number of gynecological conditions. These might include heavy bleeding, endometriosis (tissue usually lining the uterus grows outside on the ovaries), uterine prolapse, fibroids, adenomyosis (lining tissue grows within the walls of the uterus), and cancer (or precancer) of the uterus, cervix, ovary, or endometrium.

Myomectomy is a procedure used to remove fibroids, which are non-cancerous tumors that grow from the muscle layers within the uterus. Myomectomy is commonly recommended as a fibroid treatment for women who later want to have children. Traditional abdominal myomectomy may require a couple of nights in the hospital followed by four to six weeks of home recovery. But the less-invasive laparoscopic myomectomy is an outpatient procedure, and it involves lower risks of complications and only a few days of home recovery before returning to reasonably normal activity.

Less invasive, less risk

Since the laparoscopic procedures use much smaller incisions and are more precise, the body experiences a lower level of stress. “Most patients are eating and mobile shortly after surgery, and they go home the same day. Many are on nothing stronger than a low-dose oral pain reliever like ibuprofen or acetaminophen and only for a few days,” said Dr. Crawford.

There are also great psychological benefits to the less-invasive approach. Patients find the outpatient option to be far less stressful for many reasons.  Between family, work and other obligations, it can be daunting to worry about being out of commission for an extended period. The less-invasive approach helps them return to their normal routine more quickly.

Some of the most common concerns are about the procedure’s risk and how soon they will be able to return to regular activity. Patients also ask how something like a hysterectomy will affect their hormones and sexual activity. Since everyone is different, you should have an involved conversation with your gynecologist or surgeon to better understand your procedure and particular situation.

While Dr. Crawford recommended asking for a minimally invasive approach to any gynecological procedure, he also noted there are times when a traditional surgery is necessary. For example, if the uterus is greatly enlarged, it might be impossible to treat laparoscopically. “I have performed one traditional (more invasive) hysterectomy in the last 10 years,” he explained. “But you certainly should ask your surgeon.”

As with any new technology or methodology, there are generally myths that crowd the facts, so it’s important to educate yourself. “Some patients get online, watch videos, and see bad outcomes with robotic surgery cases,” said Dr. Crawford. “We maintain a quality program with metrics that are evaluated and managed every year.”

Visit your gynecologist to talk about your procedure options, or you can click here to connect with a gynecologist at Kettering Health Network.