Hysterectomy Procedures: Know the Risks

An estimated 500,000 hysterectomies will be performed in 2016, with many of them as higher risk procedures: invasive open hysterectomy, blind vaginal hysterectomy, or robotic hysterectomy procedures.

The high level of risk associated with these types of hysterectomies can lead to additional surgeries to repair delicate areas in the pelvis that can be damaged during the operation, including the bowel, bladder, ureter or blood vessels. Bowel injuries can lead to life-threatening infections that must be addressed immediately.

Open procedures leave patients with a large incision that can take up to 8 weeks to heal, and have a higher chance of pelvic adhesions forming due to scarring. These are often performed by non-specialist surgeons. Open procedures have higher risk of infection.

Beware of explanations of how “your uterus is too large to remove laparoscopically”, “you are too heavy”, or have had “a Cesarean section.” These are not true. There are safer approaches to a hysterectomy for almost all patients and any size uterus, resulting in much faster recovery, less pain, and fewer complications than open procedures.

Vaginal procedures are performed without abdominal incisions, but have no line of sight within the pelvis which can lead to injuries to surrounding structures. Other disadvantages include:

• Limited in what can be treated. Moderate to large uteri due to fibroids or other causes can be difficult to remove vaginally.
• Larger ovarian masses may be difficult to treat.
• Higher risk of bleeding with larger uteri due to bleeding from the uterine artery and ovarian arteries.
• Prior Cesarean section or surgery can cause scar tissue increasing the difficulty of the surgery. This increases the risk of complications to the bladder, bowel, and ureter.
• Inability to see and treat other pelvic problems, such as endometriosis, scar tissue, ovarian masses, cancers, etc.
• Inability to assess for bleeding or other complications after surgery.

Robotic procedures are performed with a surgeon on the other side of the room at a control panel, and often require a urologist to be on standby to perform ureter repairs. OB/GYNs often do not have privileges to perform ureter, bladder or bowel repairs for these types of surgery.

• Significantly higher cost, as compared to conventional laparoscopy.
• Increased size and number of incisions, as compared to other laparoscopic procedures with possible increasing pain and longer recovery.
• Placement of incisions throughout the abdomen and pelvis, with larger incisions increasing the risk of herniation.
• Increased complication rates and breakdown of the vaginal “cuff” for hysterectomy.

In a recent report from the Food and Drug Administration (FDA) Manufacture and User Device Experience (MAUDE), over the last 10 years, 455 injuries and 177 malfunctions from robotic surgery were reported, with the most common gynecologic procedure, hysterectomy leading in both injuries or death. There is no benefit to the patient over standard laparoscopic procedures.

A Report Card on Robotic GYN Surgery: 10 Years Later

The Better Minimally Invasive Hysterectomy: DualPortGYN

The advanced technique DualPortGYN was developed by the minimally invasive GYN specialists at The Center for Innovative GYN Care (CIGC) to take advantage of specialized techniques that help to control blood loss and map the pelvic cavity. Hysterectomies can be performed using just 2 small incisions no larger than a paper cut.

At CIGC all of our procedures are performed on an outpatient basis, either at a state-of-the-art ambulatory surgical center (ASC) or at a hospital depending on each patient’s specific needs. Patients return home the same day. Every CIGC patient is provided individualized care and attention by our fellowship trained minimally invasive GYN specialists, Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD.

“Our sole focus is minimally invasive GYN surgery,” said Dr. MacKoul “CIGC specialists provide advanced minimally invasive surgical procedures in an outpatient setting so that patients can have the best possible option for their condition. They return to their own homes the same day with much less pain, and eliminate the need for a hospital stay and all of the negatives associated with that.”

The Benefits of Outpatient GYN Hysterectomies

With open or robotic procedures, patients are often required to have a hospital stay, increasing the chance of infection.

“Hospitals can be hot spots for infections and can sometimes amplify spread,” says Tom Frieden, M.D., director of the CDC. “Patients with serious infections are near sick and vulnerable patients—all cared for by the same health care workers sometimes using shared equipment.”

At CIGC, patients experience less pain than other more invasive procedures, and after returning home the same day as surgery, they are often able to go back to work in 2 weeks or less.

Recover From Minimally Invasive GYN Surgery At Home

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 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.

Book a consultation today with Dr. Paul MacKoul, MD or Dr. Natalya Danilyants, MD.

REVIEWS

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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.