Who is a candidate for Robotically assisted Laparoscopic Hysterectomy...

Scores of women suffer from huge aching uteri, enormous painful fibroids, debilitating endometriosis and incapacitating pelvic organ prolapse. Many times they had prior abdominal surgeries and/or are obese.

In US each year hundreds of thousands of women undergo hysterectomies (removal of uteri), myomectomies (removal of fibroids), excision of severe (frozen pelvis) endometriosis and sacrocolpopexies (suspension of vagina). The majority are performed by laparotomy which is making a several inch incision through the abdominal wall in order to access the pelvic cavity. Such an incision cuts through skin, fascia and muscle. It requires a several day hospital stay and six to eight week recovery at home. It is also associated with more pain, higher risk of infection, creation of adhesions and scar tissue, weakening of the abdominal wall and hernia formation.

Fortunately, the vast majority of hysterectomies, myomectomies, excision of endometriosis and sacrocolpopexies can be performed using advanced robotically assisted laparoscopic surgery. Laparoscopy eliminates the need for the several inch long abdominal incision, thus significantly reducing the above mentioned unpleasant results and complications.

Every patient suffering from huge aching uteri, enormous painful fibroids, debilitating endometriosis and incapacitating pelvic organ prolapse is a proper candidate for such a minimally invasive surgery, regardless of the size of uterus, number/dimensions of fibroids, severity of endometriosis, extent of pelvic organ prolapse, history of prior abdominal surgeries or obesity.

These conditions present significant challenges for the common OB/GYN to perform such advanced robotically assisted laparoscopic surgery. Therefore, unfortunately, many patients are advised by their doctors, that they are not a candidate for the minimally invasive surgery. Many patients don’t seek a second opinion and end up undergoing the much more invasive surgery, laparotomy.

These patients should not be misguided from undergoing a minimally invasive surgery. Robotically assisted Laparoscopic surgery requires only four to five quarter of an inch to half an inch incisions, no hospital stay and 2-3 week recovery at home.

Author

Dr. Nathan Mordel, MD Nathan Mordel, MD, is a board-certified gynecological surgeon at Atlanta Minimally Invasive Gynecologic Surgery Center in Atlanta, Georgia. He specializes in advanced robotic, laparoscopic, vaginal pelvic surgery, including for fibroids, endometriosis, heavy and/or painful menstrual periods, pelvic organ prolapse, and urinary incontinence.