Each year, over 600,000 women are hospitalized for a hysterectomy--a procedure to remove the uterus. This can be performed as a treatment option for a life-threatening diagnosis' or the best way to relieve pelvic pain and pressure, or to stop abnormal bleeding that comes from a chronic condition. Nearly one-third of women in the United States will have had a hysterectomy by the time they turn age 60.
A hysterectomy should be considered major surgery. In the past the procedure may have involved staying several days in the hospital, experiencing a lengthy recovery time, limited post operative activity, and having a large abdominal scar. Northwest Hospital now offers patients a modern alternative to that approach. Known as minimally invasive surgery (MIS), many of the disadvantages of traditional procedures are eliminated.
The highest standards of patient care and surgical excellence are practiced by the physicians and surgical team at Northwest Hospital. The procedures performed at Northwest Hospital combine the clinical and surgical expertise of the surgeon, along with the professional attitude, experience and compassion of the highly skilled health care team.
What is Minimally Invasive Surgery?
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Minimally invasive surgery involves the use of instruments inserted through small incisions. These incisions enable fiber optic tubes, connected to television monitors, to be inserted into the patient, allowing doctors to perform surgical procedures without making large incisions.
In determining your treatment options, factors such as obesity, history of prior abdominal surgery that resulted in forming dense scar tissue, or other medical conditions should be considered. Minimally invasive surgery is sometimes called laparoscopic surgery and can now replace traditional abdominal and vaginal hysterectomy techniques. Most patients experience less pain, shorter hospital stays, quicker recoveries and less scarring following minimally invasive surgery.
Types of the Minimally Invasive Surgery Procedures
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Some of the types of procedures performed by the team of skilled surgeons at Northwest Hospital include:
- Laparoscopic Procedures: The surgeon uses a miniature camera and various specialized tools inserted through small, dime-sized incisions in the belly button and abdomen. These procedures may be only exploratory or may involve the removal of the fallopian tubes and/or ovaries, depending upon the problem being treated.
- Laparoscopically Assisted Vaginal Hysterectomy (LAVH): As with all laparoscopic procedures, the surgeon uses specialized instruments to separate the uterus (and possibly the fallopian tubes and ovaries as well) from its internal attachment to the patient's body. Then, by operating through the vagina, the attachments of the cervix to the top of the vagina are cut, allowing the uterus and cervix to be removed from the body through the vaginal opening.
- Laparoscopic Supracervical Hysterectomy, (LSH): The surgeon removes the upper two thirds of the uterus using laparoscopic tools inserted into the body through small incisions. The cervix is left intact and attached to the upper vagina, which can help provide better post-operative vaginal support while eliminating the need for the vagina to heal. The removal of the uterus from the body is accomplished through the small incisions in the abdomen using special equipment designed for that purpose.
- Total Laparoscopic Hysterectomy (TLH): This procedure uses similar incisions to an LSH, but removes both the cervix and the uterus. Unlike LAVH, there is very limited work done through the vagina.
- Total Vaginal Hysterectomy (TVH): This procedure is performed through an incision made at the top of the vagina. The incision is small and leaves no visible scar. Only patients with uterine prolapse are candidates for this type of surgery.
Not everyone is a candidate for minimally invasive surgery. Your physician will determine if MIS is an option for you.
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The surgeons at Northwest Hospital perform hysterectomies for the following conditions:
- Uterine fibroids: Usually so small that they don't cause any symptoms, these non-cancerous tumors may cause the need for a hysterectomy when they grow bigger, press against other organs and cause pain, or irregular, or excessive bleeding
- Abnormal uterine bleeding: Fibroids, hormonal changes, infection, or cancer can cause irregular, heavy or severe bleeding from the uterus. If other treatments don't work and the bleeding continues to be a problem, a hysterectomy may be an option.
- Endometriosis: This condition is caused by cells, similar to the ones found in the uterine lining, growing in other parts of the pelvis such as the ovaries or fallopian tubes. These cells bleed and the blood may create cysts. Scarring, pain or infertility can result from endometriosis.
- Uterine prolapse: Caused by childbirth, obesity and loss of natural estrogen production, ligaments and tissues in the pelvis can become weak and stretched. This leads to a condition in which the uterus moves down into the vagina and possibly even protrude from the vagina.
- Cancer: When diseases of the cervix develop into pre-cancerous conditions known as dysplasia, they can often be successfully treated without a hysterectomy. However, if cancer of the cervix or uterus is diagnosed, a hysterectomy may be the best way to stop the cancer from spreading.
If you have been diagnosed with one of these conditions, and have been told that you need to have a hysterectomy, you may want to contact a physician in the Gynecology department at Northwest Hospital to determine if minimally invasive surgery is a treatment option for you.
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Minimally invasive surgery has a variety of patient benefits, such as:
- Less pain
- Shorter hospital stay
- Faster recovery time
- Smaller scar
Head of the Division of Minimally Invasive Surgery
W. Peter Geis, M.D.
Associate Head of the Division of Minimally Invasive Surgery
David Zisow, M.D.,F.A.C.O.G.
5401 Old Court Road
Randallstown, MD 21133
For more information about Women’s Services at LifeBridge Health call 410-601-WELL (9355).