Hysterectomy is the surgical removal of the uterus and may be recommended for women with fibroid tumors. Each year in the U.S. alone, doctors perform approximately 600,000 hysterectomies, making it the second most common surgical procedure for women.1 In fact, 1 in 3 women will have a hysterectomy before age 60.1
Approaches to Hysterectomy
Surgeons perform the majority of hysterectomies using an open approach. With open surgery, your doctor makes a large abdominal incision – large enough to fit his/her hands and instruments inside your body. While open surgery allows your surgeon to see and touch your organs, there are some drawbacks for patients due to the large incision.
Minimally Invasive Hysterectomy Options
Vaginal Hysterectomy - With vaginal hysterectomy, the uterus is removed through the vagina, without any external incision. Surgeons may use this minimally invasive approach if the patient’s condition is benign (non-cancerous), or when the uterus is a normal size and the condition is limited to the uterus. With vaginal hysterectomy, surgeons have a small working space and lack of view to the pelvic organs.
Laparoscopic Hysterectomy - Laparoscopic surgery is minimally invasive – meaning surgeons operate through a few small incisions. During traditional laparoscopy, long-handled surgical instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and those images are sent to a video monitor to guide surgeons as they operate.
da Vinci Hysterectomy - With a da Vinci Hysterectomy, surgeons operate through a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.
da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.
- Learn more about da Vinci Hysterectomy
Types of Hysterectomy
There are many types of hysterectomy that are performed, depending on the patient’s diagnosis. All hysterectomies involve removal of the uterus. What can vary are which additional reproductive organs and other tissues that may be removed. Types of hysterectomy include:
Partial or subtotal hysterectomy
This procedure, also known as a supracervical hysterectomy, involves removing the uterus, but leaves the cervix intact. This decision is often based upon patient preference.
This procedure involves removing the uterus and the cervix. The vagina remains entirely intact. This is the most common type of hysterectomy performed.
Removal of lymph nodes
For hysterectomies performed for malignant conditions – such as uterine, cervical, or ovarian cancer – the surgeon will also remove certain lymph nodes. This procedure is often referred to as a lymph node dissection or lymphadenectomy. Lymph nodes will be removed in certain areas, depending upon the location and extent of the disease. Lymph node removal also helps your surgeon determine the extent or stage of your cancer, and can guide further adjuvant treatment, such as radiation therapy or chemotherapy.
Removal of the fallopian tubes and ovaries
These organs may or may not be removed during your hysterectomy procedure. This will depend upon your condition, age, and other factors. Often, the ovaries and fallopian tubes are left intact.3 Removal of the ovaries is called an oophorectomy. Removal of fallopian tubes and ovaries is called a salpingo-oophorectomy.
For this procedure, the uterus and cervix are removed.
All surgery presents risk, including da Vinci® Surgery and other minimally invasive procedures. Serious complications may occur in any surgery, up to and including death. Examples of serious or life-threatening complications which may require hospitalization include injury to tissues or organs, bleeding, infection or internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Risks of surgery also include potential for equipment failure and human error. Risks specific to minimally invasive surgery may include: A long operation and time under anesthesia, conversion to another technique or the need for additional or larger incisions. If your surgeon needs to convert the procedure, it could mean a long operative time with additional time under anesthesia and increased complications. Temporary pain or discomfort may result from pneumoperitoneum, the presence of air or gas in the abdominal cavity used by surgeons in minimally invasive surgery. Research suggests that there could be an increased risk of incision-site hernia with single-incision surgery. Results, including cosmetic results, may vary. Patients who bleed easily, who have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci® Surgery. For more complete information on surgical risks, safety, and indications for use, please refer to http://www.davincisurgery.com/safety/. Patients should talk to their doctors about their surgical experience and to decide if da Vinci Surgery is right for them. Other options may be available. Intuitive Surgical reviews clinical literature from the highest level of evidence available to provide benefit and risk information about use of the da Vinci Surgical System in specific representative procedures. We encourage patients and physicians to review all available information on surgical options and treatment in order to make an informed decision. Clinical studies are available through the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.
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