This article is sponsored by The Center for Innovative GYN Care
Complex GYN Conditions Should Not Require Long or Open Surgical Procedures
The longer a surgical procedure or recovery time, the higher the risks of side-effects.
Despite advancements in gynecological surgical techniques, a large number of women are still subjected to open procedures for hysterectomy or myomectomy. This is often the result of surgeons’ lack of laparoscopic training and experience with complex conditions like large fibroids or extensive endometriosis. Patients need to understand that it is not the extent of the condition, but the skill of the specialist.
In recent stories from celebrities (singer Monica, Real Housewife Bethenny Frankel, and Australian clothing designer Thessy Kouzoukas) announcing treatment for GYN conditions that millions of women are experiencing, too many are claiming that they are going to have major surgery with open procedures or 7-8 hour procedures. Despite the implication that celebrity also affords access to the best level of care, these women are actually experiencing out-of-date procedures, with long, painful recoveries.
KNOW WHAT TO LOOK FOR IN A GYN SPECIALIST
Advanced training for laparoscopic surgery is essential for the best patient outcomes. This includes performing state-of-the-art techniques that control blood loss and improve visibility, as well as extensive experience performing complex surgeries. Higher volume in performing laparoscopy means the surgeon has a higher exposure to complex conditions.
It is also essential that the surgeon is trained and certified to perform advanced repairs for bowel and ureters. This is especially significant when endometriosis or pelvic scarring due to inflammation creates a frozen pelvis. This condition occurs when scar tissue forms fusing the pelvic organs together. The risk of injury is high in these cases. If performed by a highly skilled laparoscopic specialist, patients will emerge from surgery and be able to return home the same day. Recovery from fibroid removal should be 10 to 14 days, hysterectomy or endometriosis excision should be a week or less. Longer recovery times will affect a woman’s quality of life.
TOO MANY WOMEN ACCEPT OPEN SURGERY AS THEIR ONLY OPTION
Bethenny Frankel recounts her experience on her website. She had an open procedure through her C-section scar. “The days in the hospital were challenging, the week after wasn’t a picnic, the scar seems a little worse than from giving birth, but, getting up and moving around a week later made my recovery way quicker than ever. My MD said he once had a patient up and about after three weeks…”
When a patient is told she has to have an open procedure, it is often because that is the level of surgery that surgeon is comfortable with, but that does a major disservice to the patient. Open surgeries have longer recovery times. In many cases, if the condition is complex, the surgery time itself can be longer.
INCREASED RISKS OF SIDE-EFFECTS WITH LONG SURGERIES, RECOVERIES
The length of surgical times and recovery times both contribute to an increase risk of long-term side-effects that can affect a patient’s vascular and neurological health.
Remaining still for too long can increase the risk of blood clots. Open procedures also have longer, more painful recovery times, which means the patient often remains inactive for long periods of time.
The neurological effects of general anesthesia can include delirium or memory-loss, and the risks increase with age or if the patient has pre-existing dementia or Alzheimers.
Longer surgeries require larger amounts of anesthesia to ensure the patient is kept from moving, as well as ensuring that there is no memory of the procedure. In recent years research into the effects of anesthesia have led multiple teaching hospitals to look into the electrical impulses active in the brain during surgery and what that could mean for managing the type and amount of anesthesia used.
SMALL INCISIONS, SHORT PROCEDURES FOR LARGE FIBROID REMOVAL & EXTENSIVE ENDOMETRIOSIS EXCISION
The specialists at The Center for Innovative GYN Care based in DC, Maryland and Northern Virginia developed LAAM fibroid removal to maintain fertility and DualPortGYN for all GYN conditions including fibroids, endometriosis, ovarian cysts, and pelvic adhesion removal. These techniques are performed as outpatient procedures, so women return home the same day. The incisions are small and placed in the midline. This strategic placement avoids the abdominal muscles, so recovery is faster. LAAM and DualPortGYN use an advanced technique called retroperitoneal dissection. The surgeon is able to see the entire pelvic cavity, and using bilateral uterine artery occlusion to ensure blood loss is minimal. This is an advancement over other procedures that do not control for blood loss, which limits the size and number of fibroids that can be removed.
The LAAM minimally invasive technique for myomectomy is an important development, as it allows the CIGC surgeons to feel all of the fibroids. This cannot be accomplished by a robot or with standard laparoscopy. LAAM patients return to themselves in about 2 weeks. LAAM uses 2 small incisions, one 5 MM incision at the belly button, and another 1.5 inch incision at the bikini line. Through the lower 1.5 inch incision, the CIGC surgeon can remove the fibroids and repair the uterus so that women who wish to maintain fertility will have a better chance of conceiving and carrying a child to term. The average LAAM procedure takes just over an hour to perform.
A DualPortGYN hysterectomy uses just two tiny 5 mm incisions, one at the belly button, and the other at the bikini line. DualPortGYN hysterectomy procedures on average take about 56 minutes.
A minimally invasive hysterectomy is recommended for women who have abnormal bleeding and pelvic pain due to adenomyosis and who are finished with child bearing. While fibroids can be removed with a minimally invasive myomectomy, additional fibroids are likely to grow. The only cure for fibroids is a hysterectomy.
Choosing the most thorough procedure for a complex GYN condition with the most experienced surgeons means a more efficient (and faster) procedure and recovery is just days. These techniques reduce the risks of anesthesia side effects as well as risks of blood clots from lack of mobility during recovery.
CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Dr. Rupen Baxi, MD is a CIGC-trained minimally invasive GYN specialist with extensive fellowship training and a respected speaker and researcher. Book a consultation at The Center for Innovative GYN Care or call 888-787-4379.