How can you determine if your surgeon has the best experience to perform the best hysterectomy procedure that will minimize your recovery time, overall pain and get you back to yourself faster?
These are some basic questions you need to ask your surgeon before your hysterectomy, and the answers that should help set a threshold for what you will accept.
QUESTIONS TO ASK YOUR GYN SURGEON BEFORE YOUR HYSTERECTOMY
HAVE YOU HAD FELLOWSHIP TRAINING IN MINIMALLY INVASIVE GYN SURGERY?
- Fellowship trained GYN surgeons have more training, skill, and surgical volume than general practitioners (these include OB/GYNs).
- Fellowship training takes two to three years to complete through an approved program after completion of residency.
- Fellowship trained surgeons devote their career entirely to minimally invasive surgery, and do not perform obstetrics.
HOW DO YOU PERFORM A HYSTERECTOMY?
If an open or robotic procedure is recommended, get a second or third opinion.
- Many non-specialists still perform open (abdominal) procedures which are more painful and have a longer recovery.
- Some surgeons are now performing hysterectomy procedures using a robot. The number of incisions, limited view, and the amount of time spent in surgery can all create complications that may necessitate a conversion to open surgery.
Other than vaginal hysterectomy, which is limited in its use due to uterine size and potential for complications as it is performed blind (without a laparoscope), the most minimally invasive procedures have 2 or fewer incisions, no larger than a paper cut. DualPortGYN procedures use two (2) 5MM incisions, one at the belly button, and one at the bikini line. Along with a technique called retroperitoneal dissection and uterine artery ligation, the surgeon can view the entire pelvic cavity and control blood loss. This allows the surgeon to avoid vital structures that could be damaged during the procedure, minimizing the risk of complications.
MORE ABOUT THE ROBOTICS CONTROVERSY AND THE UNNECESSARY USE OF POWER MORCELLATORS
- The Journal of the American Medical Association (JAMA) has published articles that clearly state that robotics is not a better approach than standard laparoscopy.
- Many surgeons who use a robot to perform minimally invasive procedures lack sufficient training in laparoscopy.
- A March 2015 committee opinion from the American College of Obstetrics and Gynecologists states: “Surgeons should be skilled at laparoscopic approaches for a specific procedure before undertaking robotic approaches. Surgeon training, competency guidelines, and quality metrics should be developed at an institutional level.”
The use of a power morcellator in a procedure to remove either fibroids or the uterus has generated a lot of attention for the potential spread of cancer by its spinning blades. The morcellator is often used to grind up material within the pelvic cavity to make it possible to remove an enlarged uterus or a large fibroid laparoscopically. With the possible risks, power morcellators should never be used for fibroid removal or hysterectomy.
If your surgeon uses a robot and power morcellator to perform hysterectomies, find a GYN surgical specialist who does not.
THE CIGC & DUALPORTGYN DIFFERENCE
At The Center for Innovative GYN Care, our surgeons have completed fellowship training in advanced laparoscopic techniques. Dr. Paul J. MacKoul, MD and Dr. Natalya Danilyants, MD have developed groundbreaking procedures. The CIGC laparoscopic hysterectomy is performed using DualPortGYN, a technique that uses two tiny 5MM incisions, one at the belly button and one at the bikini line. The incisions go through the midline, not muscle, so patients have less pain.
They have also developed LAAM, a safer, minimally invasive technique for removing fibroids and sparing the uterus to maintain fertility.
BOOK A CONSULTATION
GYN surgical specialists can often see women sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Natalya Danilyants and Dr. Paul J. MacKoul. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.
Offices are conveniently located throughout the Washington D.C. area in Rockville & Annapolis in Maryland, and, Reston in Virginia. Women looking for a GYN specialist for a laparoscopic hysterectomy, endometriosis excision or fibroid removal travel to CIGC from around the world.
CIGC TRAVEL PROGRAM
Even if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.
Learn more in our travel program.