Types of Hysterectomies Overview

According to Women’s Specialists of Plano, women in the Plano, Frisco and Dallas, Texas area have more options than ever before concerning hysterectomy treatment.  In the current year, 1 in 600,000 women will undergo a hysterectomy. For some, it will be a necessary procedure in order to cure a life-threatening condition such as cancer, severe infections or uncontrollable bleeding. For others, it will be an option to help ease the symptoms of certain conditions such as fibroids, endometriosis, pelvic pain or uterine prolapse.  When a hysterectomy seems like the right choice, it helps to know the facts and the alternatives that are available so that you can make the right choice for you and for your situation. The physicians at WSOP are available to discuss the numerous types of hysterectomies available to women, including a robotic hysterectomy.

What is a Hysterectomy?

The uterus is the pair shaped, hollow organ that resides in the pelvis and is what holds a baby during pregnancy.  When a woman has a hysterectomy either all or a part of the uterus is removed. Depending on the reason for the hysterectomy, a woman may have either a complete or total hysterectomy where both the uterus and the cervix are removed, a partial hysterectomy (sometimes called a supracervical hysterectomy) where the upper portion of the uterus is removed but the cervix remains, or a radial hysterectomy where the entire uterus, cervix and a portion of the vagina are removed.    In the majority of cases, a woman will choose to undergo a total hysterectomy.

How are Hysterectomies Performed?

Traditional hysterectomy surgical procedures are still divided into abdominal and vaginal.  Most women can be candidates for all three; but depending on the size of the uterus, tumor, condition, etc., one may be a better option than the other.  Below, is a breakdown of the types of hysterectomies-each are considered traditional hysterectomy procedures:

  • Laparoscopic: Using this method, 3 to 4 tiny incisions are made into the abdomen through which a slim, lighted, telescope instrument called a laparoscope, along with small surgical instruments, are inserted. These tools will essentially work to remove the uterus.  This method usually requires a couple of days or less in the hospital and recovery can take up to 4 weeks.
  • Vaginal: This hysterectomy method is not visible to the naked eyes.  It uses a small incision inside the vagina to remove the uterus and other organs (if needed) and typically requires 1-2 days in the hospital and up to a 4-week recovery period.
  • Abdominal (also known as Open): This hysterectomy method is the most invasive of all hysterectomies.  It requires either a vertical or horizontal incision just above the pubic bone to remove the uterus and cervix (and in some cases, other surrounding organs). This particular hysterectomy will require a longer hospital stay and is performed under general anesthesia with a recovery period up to 6 weeks.

What About the Robotic Hysterectomy?

da Vinci robotic surgery is revolutionizing the way certain procedures are performed, including a hysterectomy. Using the robotic technique, hysterectomies are being document to be more effective, easier to perform, offer a quicker recovery and are dramatically less invasive than a traditional surgical hysterectomy.

Using small incisions and then inserting miniature medical instruments and a 3D camera into the patient, the surgeon is able to maneuver the tools and seamlessly translate the movement of the fingers, wrist and hand from a separate nearby console.  All of these real-time movements are performed under a magnified, high-resolution, 3D image of the uterus.  While not all gynecological practices and groups offer this technology, the Women’s Specialists of Plano have for many years.  They feel that the investment, training, and practice that it takes to fully understand and become skilled at robotic surgery is worth it.

While robotic surgery seems like the best option for women who are candidates, one drawback is the availability of the technology.  “The da Vinci robotic surgical technique is truly the only available gynecological technology that can provide surgeons with the innate control, range of motion, fine tissue handling and 3D visualization that is characteristic of open surgery—but producing vastly different recovery times. Unfortunately, this technique takes practice, hands on experience, time to master and a nice size investment; thus, it is not offered by all gynecological groups,” says Dr. Daryl Greebon.

What Experienced Physicians Have To Say:  Robotic Surgery vs. Traditional Surgery

In a recent roundtable discussion led by the Women’s Specialists of Plano, recovery is the major difference between a robotic hysterectomy vs. traditional surgery.  During this discussion, all five of the doctors that make up this highly specialized group of gynecologists discussed the types of hysterectomies and the differences. In general the recovery from a robotic hysterectomy is the same as a traditional hysterectomy, just faster.  They divide recovery into three phases:

  • How fast a patient comes out of the anesthesia
  • How soon a patient gains back strength
  • How soon a patient gains stamina

According to Dr. Murray Fox, “With a traditional hysterectomy, the first two recovery phases take 18 to 24 hours each.  The third takes 3 – 6 weeks; with robotic surgery the first two take 6 to 18 hours and the third, just 7 – 14 days.”

Dr. Dennis Eisenberg can usually see the differences almost immediately after the surgery is performed and the patient has returned back for their post-op visit. “Side effects post-op for all types of hysterectomies will be similar, but with the robotic hysterectomy, they are smaller and minimalized.  My patients will often commend the fact that they had less pain and were quicker to return to normal function than their friends who have undergone traditional surgery.”

Dr. Daryl Greebon and Julies Monier also agree that the robotic surgery might not be for everyone, but that for those who are candidates, it is generally the more preferred option, “As far as effectiveness, each type of hysterectomy works well. Some are better in certain situations.  For instance, we have found that heavier women actually do better with the robotic technique because we can see better.  However, this particularly type of woman presents more problems for anesthesia with the robot, so she needs to be in reasonably good health to have this procedure.”

Regarding da Vinci robotic surgery vs. traditional surgery, they continue to say, “Scarring can occur with any surgery but scarring has proven to be much less noticeable with robotic which is a significant advantage since intraabdominal scarring can lead to complications with future surgeries, or cause problems such as bowel obstruction.”

While the da Vinci robotic hysterectomy technology has certainly taken the medical profession by storm, it will take time before it appears in the offices of most physicians. Training and consistent use are two key ingredients that will make the adoption a success. The Women’s Specialists of Plano in Plano, TX feel the training, price tag and commitment are not only justified, but also invaluable in terms of what they can offer their patients.  It is also up to each patient, in cooperation with their surgeon, to determine whether a robotic surgery vs. traditional surgery is in their best interest.

To learn more about the types of hysterectomies, or for additional resources on a robotic hysterecotmy, please contact the Plano, Frisco and Dallas, Texas area OBGYNs at Women’s Specialists of Plano.

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