Laparoscopc hysterectomy speeds recovery time

Less than three weeks after Angela Motto had a hysterectomy, she was back at work and feeling great.

“I’m like tossing boulders around and doing cartwheels,” Motto said with a laugh, before telling the truth. “I’m a little tired and I’m not allowed to lift anything, but other than that I feel fine.”

The Greenville resident credits her speedy recovery from a total hysterectomy to the fact that her surgeon, Dr. Stephanie Dach of Upstate Ob-Gyn, performed a laparoscopic hysterectomy. The surgery method, which is rapidly gaining popularity for suitable patients, allows surgeons to make three to five half-inch incisions in the abdominal wall instead of a gaping cut up to 8 inches long.

“This is much easier on the patient,” Dach said, “and much harder on the surgeon.”
The difficulty for the surgeon is operating only with the aid of a tiny camera inserted through one of the small incisions. The other issue is the removal of tissue, uterus, cervix and ovaries, through the same incisions. But the end result is so superior that Dach said the surgery — which she started learning to perform last year — is rapidly gaining popularity.

Advertisement

“I still think a vaginal hysterectomy is a good surgery to do,” Dach said. “But if the patient is a good candidate for laparoscopic, we’re going to do it because they feel so good afterward.”

Dr. Edward Heidtman, an Ob-Gyn at Carolina Women’s Health in Greenville, said he no longer does abdominal hysterectomies unless there is no other choice.

“I haven’t seen the statistics nationally in a while, but probably 60 percent of hysterectomies are now done laparoscopically,” he said. “We’ve taken two-thirds of the surgeries we were doing that way and given patients much better outcomes.”

Hysterectomy is the second most common major operation performed in the United States, second only to caesarian section. About 600,000 women have a hysterectomy annually.

Motto required surgery due to painful non-stop bleeding caused by fibroid tumors.

Ten years earlier she’d suffered from endometriosis and had surgery to correct that. In that operation, she went under sedation believing she was going to have laparoscopic surgery.

“But when they got there, they couldn’t do it,” she said. “So, this time I was prepared for the worst.”

Even the idea of surgery worried Motto. “I’m a very bad patient,” she said, due to a scare she had as a child. That made her apprehensive about any surgery.

“Surgery is traumatic to go through,” she said. “Even if it’s minor.”

But when she awoke from her hysterectomy and learned it had gone smoothly, she was elated.

“I consider myself very lucky that they were able to do that for me,” Motto said. “I had surgery on a Tuesday and I went home Wednesday night.”

With a traditional vaginal or abdominal surgery, the cuts are deep and long. Sutures in the abdomen or near the vagina cause discomfort during recovery. Patients are often held in the hospital for days, and recovery at home can stretch to six weeks.

“These days, with the way the economy is, people just don’t want to be out of work that long,” Dach said. “If they have a sitting job, they can sometimes return to work in one week.

“It’s still a major surgery, but the patients do so much better. They feel great. They still can’t resume everything, sexual activity or exercise for six weeks, but they can do a lot of things.”

Most women are candidates for a laparoscopic hysterectomy, Heidtman said.

“Vaginal hysterectomy is still the ultimate because then you have no incision,” he said. “But this is for everyone else.”