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Minimally invasive procedure means quicker recovery for hysterectomy patientsUsually a hysterectomy isn’t something to get excited about, but hysterectomy patients at the New Ulm Medical Center have nothing but positive things to say about the minimally invasive version of the procedure performed by OB/GYN specialist Byron Gatlin, MD. Hospitalization for the laparoscopic hysterectomies is about 24 hours, compared to a two to four day stay for traditional vaginal and abdominal hysterectomies. “The biggest success gauge for the LSH (Laparoscopic Supracervical Hysterectomy) is the quicker return to work and life,” Gatlin said. What that means for patients, such as Mary Marquardt, is they can get back to things like their painting project more quickly. “Dr. Gatlin just told me not to lift the ladder,” Marquardt said. Patients such as Donna Soukup, who had a painful recovery from another abdominal surgery 23 years ago, have their fears put at ease by taking advantage of the advances in medicine in nearly a quarter of a century. “I had a quicker, easier recovery from this surgery by far,” Soukup said. “I had requested six weeks off from my clerical job, but was able to go back half days after four weeks.” There are essentially five kinds of hysterectomy options for patients at the moment, Gatlin said: the traditional, abdominal hysterectomy where an incision is made across the entire abdomen; laparoscopic-assisted vaginal hysterectomy (LAVH) in which the incisions are made in the vagina or naval as well as tiny incisions in the abdomen; vaginal hysterectomy in which the incision is made in the vagina; total laparoscopic hysterectomy in which the cervix and uterus are removed via tiny incisions in the abdomen and naval; and laparoscopic supracervical (LSH), in which only the uterus is removed via tiny incisions made in the abdomen and naval. “My goal is to be performing 80 percent laparoscopic and vaginal procedures and only 20 percent traditional abdominal hysterectomies,” Gatlin said. About seven years ago when he first saw the procedure performed, he thought it was a passing fad. That changed when patients began specifically requesting the procedure. “Now, New Ulm Medical Center is the only facility within about sixty miles who has this procedure available.” The procedure sounds simple enough: using a harmonic scalpel to control the blood supply to the uterus and ovaries, Gatlin moves the bladder off the uterus and, if he is removing the cervix as well as the uterus, separates them from each other using the harmonic scalpel and a special tool called a morcellator to break up the uterus and cervix and pull them out through the incisions in the abdomen. It doesn’t seem quite as simple when you take into consideration all of it is done via several small incisions and a tiny camera that acts as the physician’s eyes within the abdomen during the entire procedure. “The harmonic scalpel and the morcellator make this whole thing possible,” Gatlin said. The harmonic scalpel works like a knife that coagulates – or seals – the arteries as it goes. “It is similar to cautery but with no thermal effect. Using the harmonic scalpel, we are much less likely to cause peripheral damage to nearby organs.” The morcellator is a circular scalpel and it breaks the uterus into small pieces that are able to be pulled through the small incisions. The whole procedure takes about one and a half to two hours. Gatlin has performed over 25 of the laparoscopic hysterectomies since he started doing them over a year ago. He has been performing laparoscopic assisted vaginal hysterectomies (LAVH) since he began at New Ulm Medical Center seven years ago. LAVH procedure is a combination of the traditional and the laparoscopic hysterectomy. “I reserve the LAVH procedure for when I’m trying to remove the ovaries intact without using the morcellator,” Gatlin explained. “If I have an ovarian mass and don’t want to rupture it because the fluid can contaminate the abdomen, I can’t use the morcellator.” Most hysterectomies are related to fibroid tumors or excessive bleeding, Gatlin said. If they have any cancerous or pre-cancerous tissues then they are not a candidate for the LSH procedure, but can still have the LAVH procedure, which is also a shortened recovery time from the traditional hysterectomy. Another condition that prevents a patient from having a LSH is if their uterus is abnormally large or if there is scar tissue present. Marquardt was very pleased with the outcome of her minimally invasive procedure. “I went back to full function and activity after four weeks,” she said. “A co-worker of mine had the full abdominal hysterectomy. She was out for six weeks and she said she really needed it.” Marquardt’s previous experience with a laparoscopic procedure on her bladder that was also performed by Dr. Gatlin prompted her to request the same type of procedure this time. “I couldn’t believe how well that went – so I asked if he could do that with this procedure, too,” she said. “I would definitely recommend the laparoscopic hysterectomy to anyone.” |
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New Ulm Medical Center
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