A hysterectomy is the surgical removal of the uterus, and this operation is an exceptionally common procedure with over half a million hysterectomies performed in the United States every year. Gynecologists employ the procedure to treat a range of both cancerous and benign conditions including tumors, uterine fibroids, and heavy or prolonged menstrual periods, also known as menorrhagia. Depending on the condition being treated, the patient’s age, and other factors, a hysterectomy may be performed along with a salpingo-oophorectomy – removal of the ovaries and fallopian tubes. There are several options performing a hysterectomy procedure, one of which is a Da Vinci hysterectomy, which offers patients several distinct benefits.
Hysterectomy Surgery Approaches
There are several hysterectomy surgery operations. The most “traditional” method is an abdominal hysterectomy, sometimes referred to as an open hysterectomy. In this approach, the surgeon makes an incision across the patient’s lower abdomen to access and remove the uterus. While abdominal hysterectomies are generally safe procedures, the surgery leaves a noticeable scar and is associated with a longer recovery period than other hysterectomy approaches.
The vaginal approach is the least invasive hysterectomy approach since it requires no abdominal incisions. Instead, the uterus is taken out via the vagina. The American College of Obstetricians and Gynecologists (ACOG) recommends the vaginal approach whenever possible. However, certain conditions like an enlarged uterus or large fibroids may preclude a vaginal hysterectomy.
A laparoscopic hysterectomy is a minimally-invasive approach. Although the surgeon must use abdominal incisions, these incisions are tiny ports through which the surgeon passes a small camera and instruments. Laparoscopic procedures generally have less blood loss and shorter recuperation times compared to abdominal hysterectomies.
What is a Da Vinci Hysterectomy?
There is a fourth hysterectomy approach, the Da Vinci hysterectomy. This is a minimally-invasive, robotic-assisted hysterectomy. You should know that this does not mean a robot will be performing your surgery. Da Vinci procedures are only robot-assisted, so your surgeon is always in control.
In many ways, a Da Vinci hysterectomy is similar to a laparoscopic hysterectomy. Your surgeon will use a robot controlled from the operating room to make minuscule incisions in your abdomen. The surgeon will then perform the hysterectomy using a 3D monitor and incredibly fine movements of the robotic manipulators.
The Benefits of Da Vinci Surgery
A Da Vinci hysterectomy offers patients several distinct benefits as outlined below:
Less Blood Loss
Blood loss is associated with pretty much any surgical procedure since living tissue is being incised. While blood loss is not usually a problem with most procedures, surgeons always seek to minimize blood loss to keep the patient stable and eliminate the need for transfusions. Studies have shown that the average blood loss from robotic hysterectomies is less than the blood loss from open abdominal hysterectomy and does not significantly differ from that in laparoscopic hysterectomies.
Shortened Hospital Stay
Abdominal hysterectomies can be physically traumatic for the patient. Therefore, postoperative hospital stay lengths associated with abdominal hysterectomies are usually longer than stays after laparoscopic or robotic hysterectomies. Of course, no one wants to stay in the hospital longer than necessary, and a minimally invasive approach can significantly shorten your stay time.
Quicker Return to Normal Activity
Even after returning home from the hospital, surgical patients often need additional time before returning to their preoperative activity levels. Once again, robotic hysterectomy patients typically have home recovery times similar to those of laparoscopic hysterectomy patients, and both of these groups usually experience shorter home recovery periods than abdominal hysterectomy patients.
Fewer Visceral Injuries*
Every surgical procedure carries some inherent risk. One of the possible complications of a hysterectomy is unintentional bowel injuries. However, analyses of studies have demonstrated that robotic-assisted hysterectomies have less associated bowel injuries than even laparoscopic hysterectomies. This fact reinforces the relative safety of the robotic-assisted procedure.
Experience Matters with a Da Vinci Surgeon
Robotic-assisted hysterectomies were first approved over ten years ago. During that time, gynecologists have performed hundreds of thousands of safe and effective robotic hysterectomies. The ACOG Committee on Gynecologic Practice has released an opinion stating that robotic surgery should be performed by trained and experienced gynecologists who are already adept at other hysterectomy approaches. In short, experience matters.
While there are several desirable attributes in a surgeon, you should make experience a prime criterion for your Da Vinci hysterectomy surgeon. Dr. Garofalo has performed over 1,000 Da Vinci surgeries and has vast experience with other hysterectomy approaches as well. Whomever you choose for your hysterectomy, do not hesitate to ask questions and be sure to get all the facts. While there are never any guarantees in surgery, you can help minimize your risks by being an involved and well-informed patient.
If you’re evaluating hysterectomy surgery in Connecticut, please contact Dr. Garofalo a consultation.
About the Connecticut OBGYN Practice
Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowaytan and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.
Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.
For more information, go to www.garofaloobygn.com. John Garofalo, MD, and Laury Berkwitt, APRN, can be reached for personal consultations and well woman exams by calling 203.803.1098.
*Published in “Surgical approach to hysterectomy for benign gynaecological disease (Review)” distributed by Cochrane Database of Systematic Reviews.