At Northwest Hospital in Randallstown, new advances in surgery now allow our doctors to perform what’s called “minimally invasive,” or laparoscopic, surgery. That means hysterectomies with fewer complications for common gynecological conditions such as uterine fibroids, abnormal bleeding, endometriosis and urinary incontinence.
Minimally invasive surgery most often involves the use of laparoscopes, telescope-like instruments inserted through small incisions that allow the insertion of ultra-thin fiberoptic tubes connected to television monitors. By using laparoscopes, doctors can perform many surgical procedures without the need for large incisions. Smaller incisions also mean less bleeding, fewer complications and less need for prescribed drugs.
“It makes good sense to keep the incisions as small as possible,” says David Zisow, M.D., a gynecologist and associate head of the Division of Minimally Invasive Surgery at Northwest Hospital in Randallstown. “The obvious problem with a large incision is that you are creating a large injury that takes a long time to heal. If you make a big incision, you’re going to have a patient who recovers more slowly and with more pain than someone with a small incision.”
In most cases, patients undergoing gynecological minimally invasive surgery can return home the same day as their procedure. Patients who’ve undergone minimally invasive surgery often return to work and daily activities within a week or two of their procedure, and generally with far less pain than with conventional surgery.
With hysterectomies being the most commonly performed gynecological operation – over 600,000 hysterectomies are performed annually – medical experts say it makes sense to consider minimally invasive surgery when it is appropriate. In addition to hysterectomies, procedures such as endometrial ablations (removal of the lining of the uterus to control menstrual bleeding), repair of pelvic floor hernias and removal of ovarian cysts can all be done using minimally invasive surgery techniques. Procedures such as paravaginal repair also can be remedied through laparoscopic surgeries.
Minimally invasive surgeries include the transobturator sling procedure (TOT). That involves placing a synthetic mesh tape under the neck of the bladder as a “hammock” to support the urethra in times of stress such as coughing or laughing. It can be done in a scant 15 minutes using three very small incisions, says Zisow. “The relief is immediate,” says Zisow, “and women can enjoy a return to normal bladder control after a simple outpatient surgery.”
Although minimally invasive surgery may be easier on patients, doctors say, for their part, this type of surgery is demanding, yet rewarding.
“Minimally invasive surgery is technically challenging to perform,” says Zisow. “It requires not only a surgeon skilled in the methods, but also an operating team that is specifically trained to assist not only in the methods, but also in these types of procedures. Northwest Hospital has established a team of operating room personnel who have this expertise, thereby making it possible for me to operate efficiently and effectively.”
For more information about minimally invasive surgery, call 410-601-WELL (9355).
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