Women suffering from complex GYN conditions are often living with chronic pain, but groundbreaking, minimally invasive procedures now enable women to take back their lives, pain-free. In the case of hysterectomy, the word itself often holds so much weight, patients have a hard time getting past the initial shock in order to ask informed questions. Though this procedure can be used to treat conditions that can lead to pelvic pain and abnormal bleeding, it is important to be informed to make the best decision. When a hysterectomy is recommended, women must make sure they do their research — and speak to a specialist for a second opinion.
Techniques for laparoscopic hysterectomy have been proven time and time again to be successful for treating fibroids or adenomyosis. Despite the frequency at which hysterectomies are performed (on average 600,000 procedures annually), many OBGYNs are still using open surgical methods instead of more advanced, minimally invasive, laparoscopic hysterectomy techniques — such as the DualPortGYN. OBGYNs are focused on obstetrics and often aren’t adequately trained in laparoscopic procedures, nor do they have the volume of surgeries to maintain or develop advanced skills. When physicians fail to let their patients know the range of options available to them in an effort to retain the patient in their practice, it can lead women to unnecessarily choose a more invasive procedure that requires large incisions and a longer recovery time. At The Center for Innovative GYN Care (CIGC), our experts have performed thousands of advanced laparoscopic procedures with exceptional outcomes, helping women return to their lives faster.
When facing a hysterectomy, it’s imperative to know what the procedure entails and how it will be performed. Asking the right questions, searching for a second opinion, and consulting a specialist can help avoid unnecessarily invasive hysterectomies. In most cases, an open procedure is performed not because of the complexity of the patient’s condition, but due to the limitations of the surgeon’s skill. But the relationship a patient has with an OBGYN can affect the decision-making process. Studies show more than three-quarters of women do not feel the need to seek a second opinion primarily because they trust their OBGYN.
A hysterectomy involves removing the uterus, or the uterus and cervix. Often, women fear that having a hysterectomy will make them less of a woman or will induce early menopause. Although periods will stop with a hysterectomy, menopause is the result of reduced or eliminated estrogen production, which would only happen with the removal of ovaries. Even with a hysterectomy before natural menopause, if only the uterus, or uterus and cervix, are removed, periods will stop, but hormones may not be affected and early menopause will not occur.
In the case of Tonya, a CIGC patient, she elected to have a hysterectomy but keep her ovaries. Prior to her surgery, Tonya was diagnosed with anemia due to fibroids and eventually discovered she was also suffering from adenomyosis.
“It was like having a baby, birth pains, every month. I had some 800 mg ibuprofen left from a dental procedure, and Tylenol, and that would stop the pain. Nothing else worked,” said Tonya. “I would have to stay home from work.”
After an emergency trip to urgent care for dehydration due to blood loss, her doctor referred her to Dr. Paul MacKoul, MD. He performed a minimally invasive hysterectomy using the DualPortGYN technique. Tonya was in less pain within a few days after surgery.
“It was so easy! I liked the private facility because I had one-on-one kind of care. When I came out of the surgery, there was minimal bleeding, minimal pain. You can’t even see where the stitches were.”
Tonya shared her experience with a friend who expressed the fear of a hysterectomy eliminating their femininity.
“She felt like she was giving up her womanhood. Many women don’t realize that if you keep your ovaries, you won’t go through menopause. If I had known that I could keep my ovaries, and not be forced into menopause, I would have had this surgery such a long time ago. Life has been so much better since my surgery!”
It is important for a surgeon to thoroughly explain which procedure is being performed (if anything additional to the hysterectomy), the expected recovery time, and possible complications that can arise due to pelvic adhesions. CIGC has skilled minimally invasive GYN surgeons who can explain in detail what will happen during and after the surgery.
While researching treatment for complex GYN conditions, it’s essential to select the safest, most effective procedure available. While there are a variety of surgical options for hysterectomies, the recovery of each procedure depends on the skill of the specialist, placement of the incisions, and technique used for removal, and control of blood loss. These factors all play into patient safety, surgical results, and the length and quality of a patient’s recovery.
Recent research comparing DualPortGYN, standard, and robotic laparoscopic techniques has shown that DualPortGYN (defined as laparoscopic retroperitoneal hysterectomy) had the lowest complication rates for during and after the surgery and the shortest operating time, with a one-week recovery on average.
Open procedures
With open hysterectomy procedures, patients are left with a large incision that can take up to eight weeks to heal. Open procedures have a higher risk of infection and a higher likelihood of pelvic adhesions forming after the surgery due to scarring. The high level of risk associated with an open hysterectomy can lead to additional surgeries to repair delicate areas in the pelvis that can easily be damaged during the operation. This includes the bowel, bladder, ureter, or blood vessels — and these injuries can even lead to life-threatening infections. Many doctors who do not have extensive laparoscopic training often make excuses for why a laparoscopic surgery isn’t the best fit. With a skilled specialist, an open hysterectomy is rarely necessary.
Vaginal procedures
While vaginal hysterectomy surgery doesn’t require abdominal incisions, it does eliminate sight within the pelvis, which can lead to injuries to surrounding structures. Other disadvantages include a higher risk of bleeding with larger uteri, due to bleeding from the uterine artery and ovarian arteries; and the inability to see and treat other pelvic problems, such as endometriosis, scar tissue, ovarian masses, or cancers.
Robotic procedures
Robotic hysterectomy surgery is performed with a surgeon on the other side of the room at a control panel and often requires a urologist to be on standby to perform ureter repairs. Patients who have a robotic hysterectomy can expect increased size and number of incisions, as compared to other laparoscopic procedures. They can also anticipate incisions going through muscle, which can result in increasing pain and longer recovery, as well as a longer surgical procedure — increasing the amount of time a patient is under anesthesia.
Robotic procedures for GYN conditions offer no benefit to the patient over standard laparoscopic procedures, and the skills required to perform complex laparoscopic GYN procedures are not practiced by generalists, including OBGYNs. Laparoscopic hysterectomy recovery has been proven to have overall better outcomes for patients, but choosing an experienced minimally invasive GYN surgeon has a direct impact on surgical success and recovery.
A DualPortGYN hysterectomy is one of the most minimally invasive GYN surgery techniques available and can only be performed by a trained GYN specialist. An improvement on standard laparoscopy, DualPortGYN was developed by the minimally invasive GYN specialists at CIGC to help women heal faster and create a safer procedure in the process. Hysterectomies performed with DualPortGYN offer a specialized technique that helps control blood loss and map the pelvic cavity for maximum visibility.
The CIGC specialists use just two small incisions, each no larger than a paper cut, placed in the midline area. The placement of these incisions helps patients heal faster with less discomfort, because they don’t impact abdominal muscles. DualPortGYN hysterectomies 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 are able to return home the same day and, in many cases, will see a significant improvement in pain in the first few days, although every patient is different. Every CIGC patient is provided individualized care and attention by our fellowship-trained, minimally invasive GYN specialists.
“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.”
Every woman can take control of their GYN health and get back to their life, pain-free. Women have the right to ask questions and research options before going into surgery for a complex GYN condition.
The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. Maryland offices are located in Rockville, MD and Annapolis, MD.
CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind.
Their personalized approach to 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 Paul MacKoul MD or Natalya Danilyants MD.
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