general women's health

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Robotic Hysterectomy

Postby Pedram Bral on Mon Dec 11, 2017 3:59 pm

A hysterectomy is a surgical procedure to remove your uterus or your uterus and cervix. The first procedure is known as a partial hysterectomy, and the second is called a total hysterectomy. A robotic hysterectomy, also known as a da Vinci hysterectomy (because of the name of the company that makes the device) is when a trained gynecologist performs the procedure with a computer-assisted device that enables greater accuracy.

The robotic aspect of the procedure allows your doctor to accomplish the surgery through small (half inch or smaller) incisions instead of the traditional wide incision across your belly (a procedure known as an open hysterectomy) or a minimally invasive procedure with a laparoscope. The computer-operated device provides your OBGYN real-time 3D video while directing a laparoscope and surgical instruments.

Your surgeon remains in the operating room during the entire procedure. The computer connects the surgical instruments to the doctor’s hands, translating hand movements into precise adjustments of the instruments. Robotic surgery has been successfully completed on three million people, according to the da Vinci company.

Candidates for Robotic Hysterectomy
A total or partial hysterectomy may be recommended for you if:

Cancer has been found in your uterus, cervix or ovaries.
You have a uterine prolapse, especially if it’s severe.
You suffer from endometriosis.
You have uterine fibroids that are interfering with your uterus.
You’ve had abnormal uterus bleeding or unexplained bleeding from your uterus.
If you qualify for a partial or total hysterectomy, you can get a robotic hysterectomy. The robotic procedure is especially apt for women who already bear scars from previous abdominal surgeries.

Risks from Having a Robotic Hysterectomy
A da Vinci hysterectomy needs just five small incisions, which reduces both the scars left behind and your recovery time. Additionally, this minimally invasive technique means you’ll lose less blood and experience less post-operative pain. But as with all surgeries, you have to weight the risks and potential complications. The risks from a robotic hysterectomy include:

Getting an infection from the operation
Suffering from bleeding after the surgery
Having nearby organs, such as your bladder or bowel, damaged
Developing blood clots in your legs that can harm other parts of your body
Having a bad reaction to the anesthesia used for the procedure
Staying under the anesthetic longer, which itself involves risk
Robotic Hysterectomy Steps
Controlling the surgical instruments from a computer console might seem like science fiction, but in fact, your OBGYN can better manipulate the instruments this way. The steps of this procedure are:

After you’re unconscious (either through general anesthesia or sedation), your doctor makes the necessary incisions around your navel.
Then the surgical instruments — including a laparoscope with a camera — are inserted in each opening. The specific instruments can be changed as needed.
Gas may be introduced into your abdomen to give the surgeon a better view and more room to work.
The surgeon cuts your uterus into pieces so they can be removed through the small incisions. It’s also possible that once your uterus is detached from your fallopian tubes, your doctor will remove it through your vagina.
For a total hysterectomy, your cervix is also removed. Unless your OBGYN finds evidence of disease, your fallopian tubes and ovaries are left intact, but they can be removed at this time if deemed necessary.
The instruments are withdrawn and your incisions sewn shut. The wounds are dressed.
The robotic hysterectomy procedure may take longer than a traditional hysterectomy, but it’s still easier on your body because of the minimally invasive aspects. In other words, your abdomen isn’t cut open and left open for the procedure, so you can heal more quickly and there’s less of a chance of infection. The total robotic hysterectomy surgery time, however, can reach three to four hours.

Recovering from Robotic Hysterectomy
A hysterectomy is not an outpatient procedure. You’ll spend at least one night in the hospital under observation, but you can spend two or three days there if you need it. Every women recovers at her own speed. In the hospital setting, you’ll have an IV for pain medication and a catheter in your bladder.

When you wake up, you’ll be encouraged to sit up and drink. Once you’re drinking and passing the gas that’s in your system, your nurse removes the IV and makes sure you get some food. You’ll have no diet restrictions. You’ll likely feel some pain, but you’ll get more pain medication as needed.

Nurse’s aides will get you out of bed to walk as soon as you are able, although you’ll need to wear pads because you may experience some bleeding from your vagina. Walking prevents blood clots in your legs and actually helps you heal. They’ll remove your catheter on the second or third post-op day.

Home Care While You Heal
After you’re well enough to stand, walk a little and go to the bathroom on your own, you’ll be released to finish your recovery in the comfort of your own home. Follow your doctor’s instructions fully and enlist the aid of your family and friends to make your recovery a little easier. Here are some healing tips:

Keep your incisions clean and dry. Report any drainage problems, bleeding or swelling to your doctor.
Don’t worry if you continue to experience some light bleeding from your vagina. It’s normal for it to last several days.
Don’t go overboard with exotic food, but you can resume your normal diet.
Walk every day. Walk in your home, get outside to walk and build up your strength.
Don’t lift anything heavier than 10 pounds for two weeks. Let your friends or family members do the heavy lifting for you.
Take your pain medication as needed. After the first week of home care, wean yourself off of them, taking them less often as you can tolerate the mild pain.
Do not stick anything into your vagina — including tampons or douche — for up to six weeks.
You cannot have sex for six weeks or until your gynecologist says it’s OK.
The expected total or a partial hysterectomy recovery period is six to eight weeks. Your OBGYN will request a follow-up visit, during which your progress is checked and your stitches removed. In the meantime, though, contact your doctor if you experience:

A fever
Heavy bleeding
Worsening pain
Shortness of breath
Leg pain or swelling
Chest pain
All symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition. The hysterectomy procedure, indications, options and risks should always be discussed with your gynecologist.

Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Pedram Bral
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Joined: Mon Dec 11, 2017 3:48 pm
Location: 51 East 25th Street Ste 403 New York, NY 10010

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