Each year, 600,000 American women undergo a surgical procedure called a hysterectomy, or removal of the uterus. It’s the most common women’s surgery other than childbirth by Cesarean section. Hysterectomy used to mean a rather large incision, blood loss, a long hospital stay, and a six-week recovery. Today, modern techniques and technology have advanced so that surgeons can perform hysterectomies, and many other gynecologic procedures, using a minimally invasive approach.
“In the early 1990s, it became clear that most of these procedures could be done through three or four tiny incisions, instead of a single large incision,” explains Kate O’Hanlan, MD, a gynecological cancer surgeon and pioneer in the field of total laparoscopic hysterectomy. “This method offers many benefits, including less pain and blood loss, a shorter hospital stay, faster recovery, and less time away from work and other activities.”
Minimally invasive gynecological surgery can be done two ways: using a laparoscope or a surgical robot. In laparoscopic surgery, the surgeon uses a laparoscope, a tiny camera at the end of a narrow tube that is introduced into the abdomen through a small incision hidden in the bellybutton. The physician performs the surgery using special instruments inserted through three other small abdominal incisions.
“Based on the benefits to patients, I use the laparoscope in about 98 percent of the hysterectomies I do,” reports Dr. O’Hanlan, who performs between six and 10 of the procedures at Sequoia Hospital each week.
Although laparoscopic hysterectomy has been an option for nearly 20 years, by 2005, only about 10 percent of hysterectomies were being done minimally invasively, according to Dr. O’Hanlan. For the past six years, she has taught other physicians to perform the procedure and has now trained more than 800 doctors from the U.S. and around the world.
The other minimally invasive technique Dr O’Hanlan uses for hysterectomies is robotic surgery. The da Vinci S Surgical System provides surgeons with an alternative to conventional laparoscopy, putting surgeon’s hands at the controls of a state-of-the-art robotic platform. The da Vinci S Surgical System is comprised of computer enhanced technology, robotic hands and two cameras. It enables a surgeon, who is just steps away from the patient at all times, to perform the same complex and delicate procedures through very small incisions with unmatched precision.
Open or minimally invasive? Laparoscopic or robotic? In determining the most appropriate surgery for their needs, Dr. O’Hanlan suggests that women always consult with their physician and discuss all the available options. The goal is achieving the healthiest possible outcome and, with advances in medical technology, women and their physicians now have choices.
