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Gynecology

When medications and non-invasive procedures are unable to relieve symptoms associated with uncontrollable bleeding, noncancerous tumors or fibroids, uterine cancer and endometriosis, a hysterectomy may be performed. A hysterectomy may be required for the following the conditions:

  • Noncancerous tumors or fibroids
  • Uterine cancer
  • Endometriosis Growth of the uterine lining
  • Prolapse (falling or slipping of the uterus)

Traditional Hysterectomy

A hysterectomy can sometimes be performed through the vagina. However, when the uterus is enlarged (in cases such as fibroids or cancer), an abdominal hysterectomy is preferred. This requires a 6 to 12 inch incision. In some cases, doctors may also remove the ovaries because they are thought to release hormones contributing the condition – this would be a decision between you and your physician.

da Vinci Hysterectomy

If you and your physician agree that a hysterectomy is needed, you may be a candidate for a new, less invasive surgical procedure called the da Vinci Hysterectomy. This procedure uses a state-of-the-art surgical system designed to help your physician perform a more precise, minimally invasive procedure. For most women, the da Vinci Hysterectomy offers numerous potential benefits over traditional surgical procedures.

The benefits include:

  • Less pain
  • Less blood loss
  • Less risk of infection
  • Shorter hospital stay
  • Quicker recovery and return to normal activities
  • Small incisions for minimal scarring
  • Better outcomes and patient satisfaction

How does the da Vinci Surgical System Work?

The da Vinci Surgical System is powered by state-of-the-art robotic technology. The system enhances surgical capabilities by enabling the performance of complex surgeries through tiny surgical openings. The system cannot be programmed, nor can it make decisions on its own. The da Vinci Surgical System requires that every surgical maneuver be performed with direct input from the surgeon.

Procedures performed with the da Vinci® Surgical System:

Hysterectomy:
Surgical removal of the uterus and/or other reproductive organs

Myomectomy:
Surgical removal of uterine fibroids

Sacrocolpopexy:
Surgery for uterine or vaginal vault prolapse Please discuss both options with your physician.

Pelvic and Vaginal Prolapse:
Pelvic Prolapse The uterus is held in position by pelvic muscles, ligaments and other tissues. If the uterus muscles and connective tissues weaken, the uterus can drop out of its normal position, this is called prolapse. The uterus can slip to the extent that it drops partially into the vagina and creates a noticeable lump or bulge, or an incomplete prolapse. A complete prolapse occurs when the uterus slips to such a degree that some uterine tissue is outside the vagina. Vaginal Prolapse Pelvic prolapse is usually accompanied by some degree of vaginal vault prolapse. Vaginal vault prolapse occurs when the upper part of the vagina loses its shape and sags into the vaginal canal or outside the vagina. Pelvic prolapse may also involve sagging or slipping of other pelvic organs, including the bladder, the urethra and rectum. Symptoms may include: Sensation of sitting on a small ball Heaviness or pulling in the pelvis Pelvic or abdominal pain Pain during intercourse Protrusion of tissue from the opening of the vagina Repeated bladder infections Vaginal bleeding or an unusual or excessive discharge Constipation Frequent urination or an urgent need to empty your bladder Symptoms may worsen with prolonged standing or walking due to added pressure placed on the pelvic muscles by gravity. This condition may be caused from childbirth, previous surgeries, and obesity.

Non-Surgical Treatment Options

There are a number of non surgical options that are available for you to discuss with your physician.

  • Kegel Exercises - Special exercises, called Kegel exercises, can help strengthen the pelvic floor muscles.
  • Vaginal Pessary - A pessary is a rubber or plastic doughnut-shaped device that fits around or under the lower part of the uterus (cervix), helping to prop up the uterus and hold it in place. A health care provider will fit and insert the pessary, which must be cleaned frequently and removed before sex.
  • Estrogen Replacement Therapy - Taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone. Taking estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus. However, there are some drawbacks to taking estrogen, such as an increased risk of blood clots, gallbladder disease and breast cancer. The decision to use ERT must be made with your doctor after carefully weighing all of the risks and benefits.

Surgical Treatment Options

A sacrocolpopexy is a procedure in which the vagina is lifted back into its proper position using a synthetic mesh. Prolapse surgery has traditionally been performed as open surgery. A long horizontal incision is made in the lower abdomen to access the pelvic organs. Prolapse surgery can also be performed minimally invasively – through small incisions - with laparoscopic surgery. da Vinci® Surgery/Less Invasive Surgery If your doctor recommends surgery to treat pelvic prolapse, you may be a candidate for da Vinci Sacrocolpopexy. Using state-of-the-art technology, da Vinci Surgery requires only a few tiny incisions, so you can get back to your life faster. The da Vinci System enables your doctor to operate with enhanced vision, precision, dexterity and control. da Vinci Sacrocolpopexy offers several potential benefits over traditional open surgery, including:

  • Significantly less pain
  • Smaller incisions
  • Less blood loss
  • Less risk of infection
  • Shorter hospital stay
  • Quicker recovery and return to normal activities
  • Small incisions for minimal scarring
  • Better outcomes and patient satisfaction

As with any surgery, it is important to talk to your doctor about all treatment options, including the risks and benefits. This information can help you to make the best decision for your situation.

Learn more about our GYN Robotic Surgery Training Epicenter >>