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da Vinci Procedures - Hysterectomy
Physicians perform hysterectomy – the
surgical removal of the uterus – to
treat a wide variety of uterine
conditions. Each year in the U.S. alone,
doctors perform approximately 600,000
hysterectomies, making it the second
most common surgical procedure.1
Types of Hysterectomy
There are various types of
hysterectomy that are performed
depending on the patient’s diagnosis:
- Supracervical hysterectomy –
removes the uterus, leaves cervix
intact
- Total hysterectomy – removes the
uterus and cervix
- Radical hysterectomy or modified
radical hysterectomy – a more
extensive surgery for gynecologic
cancer that includes removing the
uterus and cervix and may also
remove part of the vagina, fallopian
tubes, ovaries and lymph nodes in
order to stage the cancer (determine
how far it has spread).
Approaches to Hysterectomy
Surgeons perform the majority of
hysterectomies using an “open” approach,
which is through a large abdominal
incision. An open approach to the
hysterectomy procedure requires a 6-12
inch incision. When cancer is involved,
the conventional treatment has always
been open surgery using a large
abdominal incision, in order to see and,
if necessary, remove related structures
like the cervix or the ovaries.
A second approach to hysterectomy,
vaginal hysterectomy, involves removal
of the uterus through the vagina,
without any external incision or
subsequent scarring. Surgeons most often
use this minimally invasive approach if
the patient’s condition is benign
(non-cancerous), when the uterus is
normal size and the condition is limited
to the uterus.
In laparoscopic hysterectomy, the
uterus is removed either vaginally or
through small incisions made in the
abdomen. The surgeon can see the target
anatomy on a standard 2D video monitor
thanks to a miniaturized camera,
inserted into the abdomen through the
small incisions. A laparoscopic approach
offers surgeons better visualization of
affected structures than either vaginal
or abdominal hysterectomy alone.
While minimally invasive vaginal and
laparoscopic hysterectomies offer
obvious potential advantages to patients
over open abdominal hysterectomy –
including reduced risk for
complications, a shorter hospitalization
and faster recovery – there are inherent
drawbacks. With vaginal hysterectomy,
surgeons are challenged by a small
working space and lack of view to the
pelvic organs. Additional conditions can
make the vaginal approach difficult,
including when the patient has:
- A narrow pubic arch (an area
between the hip bones where they
come together)2
- Thick adhesions due to prior
pelvic surgery, such as C-section3
- Severe endometriosis4
- Non-localized cancer (cancer
outside the uterus) requiring more
extensive tissue removal, including
lymph nodes
With laparoscopic hysterectomy,
surgeons may be limited in their
dexterity and by 2D visualization,
potentially reducing the surgeon's
precision and control when compared with
traditional abdominal surgery.
da Vinci Hysterectomy
A new, minimally invasive approach to
hysterectomy, da Vinci
Hysterectomy, combines the advantages of
conventional open and minimally invasive
hysterectomies – but with far fewer
drawbacks. da Vinci
Hysterectomy is becoming the treatment
of choice for many surgeons worldwide.
It is performed using the da Vinci
System, which enables surgeons to
perform surgicall procedures with
unmatched precision, dexterity and
control. Read about what may be the most
effective, least invasive approach to
hysterectomy –
da
Vinci Hysterectomy.
- Center for Disease Control.
Keshavarz H, Hillis S, Kieke B,
Marchbanks P. Hysterectomy
Surveillance — United States,
1994–1999. Morbidity and
Mortality Weekly Report.
Surveillance Summaries. July 12,
2002. Vol. 51 / SS-5. Page 1.
www.cdc.gov/mmwr/PDF/ss/ss5105.pdf
- Harmanli OH, Khilnani R,
Dandolu V, Chatwani AJ. Narrow
pubic arch and increased risk of
failure for vaginal
hysterectomy.
Obstet Gynecol. 2004
Oct;104(4):697-700.
- Paparella P, Sizzi O,
Rossetti A, De Benedittis F,
Paparella R. Vaginal
hysterectomy in generally
considered contraindications to
vaginal surgery.
Arch Gynecol Obstet. 2004
Sep;270(2):104-9. Epub 2003 Jul
10.
- Johnson N, Barlow D, Lethaby
A, Tavender E, Curr L, Garry R.
Methods of hysterectomy:
systematic review and
meta-analysis of randomised
controlled trials.
BMJ. 2005 Jun
25;330(7506):1478. Review.
While clinical studies support
the effectiveness of the da
Vinci® System when
used in minimally invasive surgery,
individual results may vary. Surgery
with the da Vinci Surgical
System may not be appropriate for
every individual. Always ask your
doctor about all treatment options,
as well as their risks and benefits.
For additional information on
minimally invasive surgery with the
da Vinci® Surgical System
visit
www.davincisurgery.com |
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