HYSTERECTOMY

What is a hysterectomy?

Deciding whether or not to have a hysterectomy, or surgical removal of the uterus, is a weighty and personal decision. Dr. Garofalo can work with you to determine whether a hysterectomy is the best solution for your symptoms and conditions.

If you're considering a hysterectomy, you're not alone. More than 600,000 hysterectomies are performed in the United States every year, and a third of all women in the United States can be expected to have a hysterectomy by age 60.

Conditions that can be treated via hysterectomy include:

• certain types of pre-cancererous conditions and cancers of the uterus or ovaries
• severe endometriosis (improper growth of the uterine lining)
• improper growth or location of the placenta (postpartum treatment)
• genetic conditions predisposing to cancer

DETAILED PATIENT EDUCATION

PATIENT TESTIMONIAL - Maureen's da Vinci hysterectomy experience

Types of hysterectomy

If you decide to have a hysterectomy, two variations of the surgery can be performed, depending on your diagnosis. A supracervical hysterectomy removes the uterus but leaves the cervix intact, while a total hysterectomy removes the uterus and cervix. With either type of hysterectomy, the ovaries can be left intact so that the hysterectomy does not cause any hormal changes or result in uncomfortable symptoms like hot flushes.

Hysterectomies are generally conducted using one of three main approaches. These approaches, along with their advantages and disadvantages, are described below.

“Open” hysterectomy:

An “open” hysterectomy, which is performed through a 6- to 12-inch abdominal incision is necessary in some situations such as ovarian cancer, severe endometriosis, or severe scarring from multiple prior surgeries. However, like any abdominal surgery, abdominal hysterectomy may result in more blood loss, a longer hospital stay, and longer recovery time (up to six weeks).

Vaginal hysterectomy:

Vaginal hysterectomy involves removal of the uterus through the vagina, without the need for an abdominal incision.

Laparoscopic hysterectomy:

A laparoscopic hysterectomy is performed using a fiber-optic scope (a laparoscope) that transmits an image of the operative field to a video monitor that Dr. Garofalo uses to guide the operation. Two or three operating instruments are usually placed through small abdominal incisions that measure less than one half-inch in length. By avoiding the need for large abdominal incisions, patients who have a laparoscopic hysterectomy can usually be discharged from the hospital less than 24 hours after the procedure, and experience significantly less postoperative pain and return to daily activities in about one week.

Da Vinci hysterectomy:

Dr. Garofalo also offers a procedure called da Vinci hysterectomy, which provides the advantages of laparoscopy but with the control and precision needed for a procedure of this complexity. Part of the da Vinci® Surgical System (link to da Vinci subpage to Advanced Gyn), da Vinci hysterectomy is a state-of-the-art surgical procedure that uses very small abdominal incisions and computer technology to convert Dr. Garofalo’s hand movements into precise micro-movements of the da Vinci instruments.

Compared to open surgery, women who undergo this procedure typically experience less pain, bleeding, and scarring, with a shorter hospital stay and faster recovery.

Dr. Garofalo's hysterectomy experience

Dr. Garofalo has performed more than 1,000 hysterectomies over 25 years of medical practice.