Tech + Health

03.30.14

A New Hysterectomy Procedure Eliminates Massive Scarring and Long Recovery Time. So Why Aren’t More Doctors On Board?

A new procedure for hysterectomies, done via robotic arm via a single incision, results in no scarring and little downtime. But the procedure has yet to gain the support of the medical community.

From the age of ten, I have dealt with debilitating periods. At times I was forced to wear diapers, hunched over in agony because I couldn’t find relief. Pop an Aleve or a Percocet for the pain? Yeah right. Aunt Flo was impervious to such futile attempts.

When I was prepubescent, I thought girls who wished for their passage into womanhood were out of their minds. As the years passed, I envied women who nonchalantly mentioned their periods as nothing more than a minor irritation.

I tried everything from the traditional to the outlandish. Doctors prescribed birth control pills when I was just 11 years old; in my 20s, I trialed hormone injections and the Nuva Ring. I underwent an endometrial ablation in my 30s, rendering my periods worse than ever. Most recently I tried acupuncture, Chinese herbs, raw apple cider vinegar, and chamomile tea.

140328-hysterectomy-embed02
Dr. Garg and team operating on the author. ()

My search for a cure ended when I became the first person in San Diego to undergo a single-site hysterectomy at Scripps Mercy Hospital San Diego.

On March 14, Scripps OB/GYN Anupam “Bobby” Garg, M.D., removed my uterus and fallopian tubes through a single half-inch incision in my navel using the da Vinci surgical robot. The da Vinci surgical robot eradicates the need for a lengthy hospital stay, drastically reduces recovery time, and leaves little to no abdominal scarring.

For over two decades I consulted with specialists. Scans yielded little beyond the occasional ovarian cyst. I was repeatedly informed it was just bad luck and handed yet another prescription. The only cure, doctors said? Submit to major surgery, a weeklong hospital stay, and an excruciating, months’ long recovery through traditional hysterectomy.

In seeking personal anecdotes, most women shared with me their grandmother or mother’s experiences. The information was decades-old and reflective of what I might expect should I opt for this “solution.” The prospect was terrifying. Through research I discovered two additional alternatives: laparoscopic-assisted vaginal hysterectomy and total laparoscopic hysterectomy. While promising, I wondered if there was another option.

“The robotic-assisted, single-site hysterectomy offers less pain and blood loss, fewer complications, decreased risk of infection, minimal scarring, and quicker recovery times.”

Thanks to my days working in Continuing Medical Education, I recalled the da Vinci robotic surgery method and wondered about its use in hysterectomy. Through more research, I learned it was a viable option. The robot’s arms and wrists can be manipulated with greater agility than that of its human counterpart, while the 3D high-definition viewing system provides the surgeon better overall control.

After discussing the downtime with my husband and employer, I resolved to advocate for myself. As patients, we often worry about insulting our doctors by seeking second and third opinions, but it was time to worry about myself. It was then that I met Dr. Garg. He was outstanding and I immediately felt comfortable in his care. After a lengthy discussion of my medical history and an exam, he agreed to perform the surgery.

The day before the procedure, my period made one last appearance. My blog entry from that day reads:

I am in my bed with tears in my eyes…my period has arrived with a vengeance as if to say, “Escape? No way! My final farewell is one you are going to remember!”

…I have been up, in pain, since just past midnight. I’ve closed my eyes, off and on, wishing it away… Today is going to be a rough day…

Finally it was time to leave for the hospital. I checked in, and the nurse wheeled me back and prepped me. My husband was allowed to join me where he remained by my side until I was rolled into the operating room. Dr. Garg arrived to confirm the procedure and ask if I had any questions, and the anesthesiologist ordered a painkiller. It was time.

During the surgery, a port for the robot’s arms (guided by Dr. Garg at a nearby station) was placed in my belly button. The 3D high-definition camera provided magnified images of my tissues, nerves and, uterus for clearer handling during the surgery.

According to Dr. Garg, all the steps in traditional surgery—cutting, clamping, or sewing—can be done with the da Vinci through one tiny incision. As a result, the robotic-assisted, single-site hysterectomy offers less pain and blood loss, fewer complications, decreased risk of infection, minimal scarring, and quicker recovery times. He adds, “This is a very exciting development in women’s health. It still allows us to perform the same surgery we currently do, but with a much more appealing cosmetic result and potentially faster recovery. It offers hope to many patients who are dealing with painful and even debilitating conditions by giving them a less invasive treatment option.”

140328-hysterectomy-embed
The single incision made by the da Vinci robot. ()

However, there are medical professional naysayers who question this method. They maintain that the alternatives are cheaper. Additionally, many surgeons are not approved to perform da Vinci robotic single-site hysterectomies.

As a woman, this is unacceptable. My health and my time are priceless. I spent one night in the hospital and was walking a day after the surgery, stopped taking all painkillers within two and a half days, and am now able to drive. A pleasant surprise: I should return to the office after being out for two weeks. You cannot put a price on that.

I understand that my decision is not for everyone, and I don’t advocate a woman remove her uterus to alleviate cramps that accompany a normal cycle. However, for those who feel there is no hope, I’m here to say otherwise. I’m hopeful my story will let others know there are answers, and encourage those who are suffering to find a health care provider who will listen. Answers are out there. Don’t stop until you find them. I for one am so grateful I didn’t.

I used to plan my life around my periods. Now I can just plan my life.

Period.