Vim & Vigor - Fall 2018 - 51

Options to treat endometriosis
include surgical removal of
endometrial growths and scar
tissue, or endometrial ablation,
an outpatient procedure to
remove the lining of the uterus.
Conservative treatment for
uterine prolapse may include a
removable support device called
a pessary.

PHOTOS BY GETTY IMAGES

What surgical
approaches can
be used?

Today hysterectomies are
performed in a variety of ways.
A woman's gynecologist and
surgeon, in consultation with
the patient, will determine
which surgical approach is
most appropriate.
Here are some of the
common surgical approaches
for hysterectomy:
3 Vaginal hysterectomy is
removal of the uterus through
the vagina. This surgery
requires no external incision
and leaves no subsequent
scarring. It is most appropriate
when the condition is benign
and limited to the uterus. It
is not suitable when patient
chooses to preserve her uterine
cervix. It is also not relevant
when the uterus is very large,
or the patient has severe
endometriosis or extensive
pelvic adhesions.
3 An "open" or traditional
approach requires a large
abdominal incision. This is used
when treating advanced cancer,
as it increases the chances of
removing all the cancer. Open

hysterectomy is needed only in
a minority of cases.
3 Conventional laparoscopic
hysterectomy is a minimally
invasive approach that utilizes
small incisions. Aided by a
camera, the surgeon directly
handles the instruments to
control their movements.
3 Robot-assisted laparoscopic surgery is similar to conventional laparoscopic surgery,
utilizing tiny incisions. But the
surgeon handles very small, very
precise instruments via a console.
Robotic surgery allows the surgeon unmatched precision, dexterity and control. Robotic surgery
is well suited for patients with a
large uterus, severe endometriosis
or pelvic adhesions.
Patients undergoing vaginal,
laparoscopic and robot-assisted
laparoscopic hysterectomies may

have faster recoveries and be
discharged home the same day
of surgery.

How quickly will
I recover?

With minimally invasive surgical techniques, the recovery
period will generally last about
two weeks. With open surgery,
expect a six- to eight-week
recovery. Afterwards, depending on whether the ovaries
were left intact, a woman may
enter menopause. If so, hormonal treatment is an option
for managing menopausal
symptoms and can be determined in consultation with
your gynecologist.
Nathan Mordel, MD, is an
obstetrician and gynecologist
affiliated with Gwinnett Medical
Center. ■

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r.org /davinci.
Learn more at gwinnettmedicalcente

FALL 2018

http://www.gwinnettmedicalcenter.org/davinci

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