Laparoscopic Hysterectomy & Myomectomy
At the Advanced Women’s Health of Nashville, we specialize in laparoscopic hysterectomy and myomectomy, having perfected our expertise over years of experience. Miniaturized instruments, with the additional dexterity provided by the da Vinci robot, allows more women to avoid open surgeries during these delicate procedures.
The invention of the laparoscope has brought huge leaps forward and benefits to women facing hysterectomy. Now, instead of one large wound in either the abdomen or vagina, through which the uterus was removed, the patient has a few very small ones. These heal faster, give less post-operative pain, bleed less and allow the patient to go home sooner. Very often, the patient stays in the hospital overnight before going home to recover for a couple of weeks.
The laparoscope is a small camera, just 1/2 inch in diameter. It’s inserted into the abdomen through, or close to, the belly button and allows the surgeon to see all the pelvic organs. Two other small incisions are made on either side of the abdomen, which allow the surgeon to manipulate instruments with her hands and perform the operation.
Laparoscopic hysterectomy is made even more delicate and precise with the aid of the da Vinci robot, a sophisticated piece of technological machinery that can move in more directions than traditional laparoscopic instruments. This additional movement gives far greater dexterity and accuracy. At the heart of the da Vinci robot is a viewing console that gives a highly magnified 3D view inside the patient’s body. The miniaturized robotic instruments that perform the surgery respond in real time to the surgeon’s manipulations, exactly mimicking wrist, hand and finger motions. The da Vinci robot has revolutionized laparoscopic hysterectomies, meaning more than ever can be done in this revolutionary way.
Myomectomy is the removal of uterine fibroids, leaving the uterus in place and capable of supporting a pregnancy. Myomectomy is especially favored by women who want to have children in the future or those who wish to avoid a hysterectomy.
Uterine fibroids can range in size from very small to as large as a basketball. When they’re very large, they put pressure on other pelvic organs, causing pain, but even very small fibroids in the uterus can cause intense, prolonged monthly bleeding and long-lasting pain. The reason for much of the pain associated with fibroids is that the wall of the uterus needs to contract in order to stop bleeding during the monthly cycle. The fibroids, being hard muscle tumors, prevent the uterine muscles squeezing effectively so they contract harder, leading to more pain, for longer.
Laparoscopic myomectomy is performed through just four, small abdominal incisions that range in size from 1/4 to 1/2 inch in size. One incision is for the camera that allows the surgeon to see the fibroids, with the other three allowing access to the delicate instruments that perform the operation. The surgeon’s hands move the instruments, with enlarged images on a TV monitor giving a clear vision of what is happening. Even very large fibroids can be removed in this way, as the fibroid can be cut up into small pieces for removal.
With the aid of the da Vinci robot, a laparoscopic myomectomy is even more precise and allows for even greater control, especially when closing the uterus after surgery. Better closure means a stronger uterus, more capable of holding a pregnancy.