Patients who have minimally invasive surgeries typically can resume their normal activities much more quickly than those who have traditional surgeries, and many minimally-invasive surgeries can be performed using sedation or nerve blocks, avoiding general anesthesia and its attendant risks.
Laparoscopic Hysterectomy
Laparoscopically assisted vaginal hysterectomy is performed using a scope and high resolution camera in your belly button, and usually two small incisions low and to the sides of the abdomen. Complex surgeries formerly requiring open abdominal surgery can now be performed with laparoscopy.
Many of these surgeries involve conservative treatment of ovarian cysts or endometriosis as well as hysterectomy. When the entire uterus us removed, including the cervix, many times the organs are removed through the vagina.
This is called laparoscopically assisted vaginal hysterectomy. Removal of the cervix is advised when there is a history of abnormal pap smears, and sometimes pelvic pain. When the vagina is cut, pain levels are higher, and many times an overnight stay is needed.
The only less painful method of hysterectomy is to leave the cervix with a Laparoscopic SupraCervical Hysterectomy (LASH), where the vagina is not cut. The uterus feels pain differently, and leaving a small part of the cervix attached to the vagina is less painful, and does not require the top of the vagina to heal.
This results in faster recovery, faster return to sexual functioning, no shortening of the vagina, and continued lubrication by cervical secretions.
This surgery is usually performed as outpatient day surgery. All hysterectomies involve only the uterus. Whether the ovaries and tubes are removed is completely unrelated to the hysterectomy itself and will be discussed pre-operatively with Dr. Daum, M.D.
In order to reach maximum understanding and planning, a preoperative visit with Dr. Daum, M.D. is a part of every operative procedure. Some women return to work as early as 3 to 5 days post LASH.
Robots are not needed for this or any other minimally invasive hysterectomy. It was gratifying when the president of the American College of OB/GYN stated that there was no justification for robotics in minimally invasive hysterectomy.
One must consider the expense, but also there are more incisions, which are are high on your abdomen and remain visible on your tummy. Who wants that when it's not needed. Robotics had applications in other specialties, but is mostly hype and advertising in Gynecology. Dr. Daum, M.D. has chosen not to perform robotic surgery even though training was offered by the hospital.
Diagnostic Laparoscopy
Laparoscopic surgery, also called band-aid surgery, or minimally invasive surgery is one method of performing many different operations with less pain and a quicker recovery.
What kinds of surgery can be performed with laparoscopy?
Most pelvic operations can be performed with laparoscopy such as evaluation and treatment of endometriosis, ovarian cysts, tubal pregnancy, investigation of pelvic pain and infertility, and even hysterectomy.
Why choose laparoscopy over more traditional approaches?
Laparoscopic surgery results in less post operative pain and a more rapid return to normal activity. Laparoscopic procedures can usually be comfortably performed as outpatient procedures.
Laparoscopic incisions are nearly invisible and result in great cosmetic results Choose your laparoscopic surgeon carefully, experience and qualifications vary widely from doctor to doctor. Laparoscopy is not the best approach for some women. Make sure your surgeon is experienced in the procedure you need, and is confident your operation can be completed laparoscopically. Conversion of laparoscopic procedures to open abdominal operations should be uncommon.
Hysteroscopic Surgery
Hysteroscopic surgery is performed using a scope to operate inside the uterus. As the hysteroscope is placed through the vagina, there are no incisions. Among the most common and useful procedures performed involve treatment of endometrial polyps and uterine fibroids. Endometrial ablation is performed with the hysteroscope.
After the scope is inserted, a diagnosis of the problem can be determined, photographed, and the most appropriate treatment for your individual problem can be determined. Hysteroscopic surgery is relatively painless, and can almost always be performed as outpatient day surgery with return to work in 1 to 3 days.
Endometrial Ablation
Endometrial ablation is an outpatient procedure performed through the vagina that can stop your periods forever! Endometrial ablation is an office procedure which destroys only the inside bleeding portion of the uterus. In 1992, Dr. Daum, M.D. performed the first ablation in the Methodist hospital system.
Endometrial ablation is not a hysterectomy, it does not cause menopause or change in your own hormonal production. There are no incisions, and pain is minimal. Most women can return to work in one day. Until recently the procedure was limited to the operating room, but now can be safely and painlessly performed in the office.
The office setting is less expensive, more comfortable, and just as effective. A full operating room team comes to the office, complete with two nurses and an anesthesiologist. Light general anesthesia is used, you don't feel a thing. Dr. Daum, M.D. uses the Novasure technique, with overall satisfaction rates of 92%.
Some women will have some residual spotting each month, but the majority will have no more periods at all. If you suffer from excess menstrual bleeding and want to avoid hysterectomy, call Dr. Daum, M.D. and see if ablation is right for you.