Advances in medicine have lowered the risks of many surgeries to the point that many are now considered minimally invasive procedures. For women who need a hysterectomy – the surgical removal of the uterus – these advances have made this surgery safer and less invasive than ever before.
In the past, a hysterectomy traditionally required open surgery with a large incision in the lower abdominal area, a minimum of several days in the hospital, and weeks or even months of recovery. Pain could be significant and, as with any open surgery, there were greater risks of complications, such as bleeding and infection.
Today, thanks to recent improvements in robotic surgery technology, hysterectomies can be completed through a one-inch incision hidden in the belly button.
“This innovative method provides a safer and more precise procedure. All the things that are normally done in surgery can be done with these really small instruments through that one incision,” said Bruce Kahn, MD, an obstetrician and gynecologist at Scripps Clinic and member of the Scripps Minimally Invasive Robotic Surgery Program.
This technique, referred to as a single-site hysterectomy offers significant advantages for patients, including:
- Quicker recovery
- Shorter hospital stay
- Less blood loss
- Less pain
- Reduced risk of complications
- Reduced need for narcotic pain medicine
- Smaller incisions resulting in minimal scarring
Hysterectomy is the most common gynecologic surgery in the United States. Studies show that by age 60, more than one-third of women in the US will have had a hysterectomy.
Hysterectomy is often the recommended treatment for numerous reproductive issues when more conservative treatments, such as medications, have been unsuccessful. Hysterectomy may be necessary for several conditions, including uterine or cervical cancer, uterine fibroids, menstrual disorders or severe endometriosis, a painful condition which occurs when uterine tissue grows outside of the uterus.
Each year as many as 600,000 women have a hysterectomy in the US. It is the second most common surgery among women in the US. The most common surgery for women is childbirth by cesarean delivery (C-section).
In many cases, traditional open surgery has been replaced by laparoscopic surgery that requires several small incisions placed in the abdomen instead of a large incision.
Several thin instruments, along with a video camera attached to a telescope, are inserted through the incisions. The camera transmits an image of the internal organs onto a television monitor, and the surgeon uses the image as a guide. This type of minimally invasive surgery has fewer risks than open surgery and provides additional benefits such as reduced length of surgery, less pain, less blood loss, a shorter hospital stay and recovery time, and lower cost. However, it does result in several small scars.
Single-site robotic hysterectomy provides all of the benefits of minimally invasive surgery, but in most cases will leave no visible scar at all.
Robotic surgery provides several other advantages over traditional laparoscopic surgery as well. These include a true 3-D view of the surgical field and more precise replication of the surgeon's hand motions. Single-site robotic technology uses curved tubes which allow surgeons to operate from several angles using just one insertion site.
“When the surgeon is operating at the robotic console, it is truly like having tiny hands in the operating field,” Dr. Kahn says. “This allows more precise and safer tissue dissection, and is one key to allowing the surgery to proceed smoothly.”