Not Your Grandma’s Hysterectomy

Much has changed since your grandmother was a child. In the last century, most folks grew up with rotary telephones. Now we walk around with telephones that are personal computers in our pockets. Your grandmother grew up with a handful of local and broadcast television channels, but now we have access to hundreds of channels that cover every interest you can imagine.


When your grandmother was growing up, hysterectomies generally happened with a large incision in your abdomen, removing your ovaries and instant menopause were part of the package, hospital stays took days, and recovery might take 8 weeks.  Similar to other areas of our lives, much has changed in gynecologic surgery, but are you being offered a hysterectomy using surgical techniques of the age of your grandmother’s childhood?


Reflecting general advances in medicine, gynecology offers newer surgical options with better recovery times. The group of new techniques are called minimally invasive surgery. Despite the availability of minimally invasive surgery, most women in this country still have their hysterectomy with a large incision that creates more complications and delays recovery.


Instead of a big incision, in minimally invasive surgery, a hysterectomy can be performed through small holes in the abdomen with a laproscope or a robot or a small incision in the vagina.  A laproscope is a small camera and instruments are placed into the abdomen but controlled from the outside. Robotic surgery is similar but with the addition of robotic control.  Vaginal surgery uses no holes in the abdomen and is performed through the natural orifice of the vagina.  All of these approaches decrease complications and recovery time.  Most women stay in the hospital for one night or even less.


In the past, ovaries were removed at the time of hysterectomy even if they appeared normal and women patients had no family history of ovarian cancer.  But that causes instant menopause and can have an adverse effect on bones and sexual function. Additionally, recent studies have shown that women at low risk for ovarian cancer can have increased risk of dying when all causes are considered. Yet, still many women are having ovaries routinely removed just because a hysterectomy is being performed.


It is time for more women to take advantage of modern medicine.  If you are being offered a hysterectomy, ask about these issues. Does you doctor routinely use a minimally invasive technique? Have you considered a  second opinion if you doctor doesn’t? There are times when minimally invasive surgery may not be the best choice, but are you really confident this is one of those times?


Are you using a black and white floor model TV? Then don’t get last century’s hysterectomy either.