Our Summary

The research paper investigates how certain challenging factors influence the trend of performing laparoscopic hysterectomies (a minimally invasive surgery to remove the uterus) over a period of 24 years. The study involved 7558 women who had their uterus removed for non-cancerous reasons between 1995 and 2018 at Bursa Uludag University Hospital in Turkey.

The researchers specifically looked at the impact of obesity, having had at least three previous abdominal surgeries, and having a large uterus (weighing 500g or more) on the rates of three types of hysterectomies: abdominal, vaginal, and laparoscopic.

The results showed a significant increase in the use of laparoscopic hysterectomies over the years, rising from just 2.4% of all hysterectomies in 1995 to 44.7% in 2018. This implies that the use of this surgical method has greatly increased over time.

Moreover, the study found that the proportion of obese patients undergoing laparoscopic hysterectomy increased from 1% to 37%. Also, the rate of patients who had at least three previous abdominal surgeries increased from 0% to 32.2%, and those with a large uterus from 0% to 32.8%.

The researchers concluded that the trend of using laparoscopic hysterectomy is increasing even in more challenging cases. Factors such as obesity, having had multiple surgeries before, and having a large uterus are no longer seen as barriers to using this surgical method.

FAQs

  1. Has the rate of laparoscopic hysterectomy increased over the years?
  2. Does obesity, previous surgeries, or having a large uterus affect the ability to undergo a laparoscopic hysterectomy?
  3. How has the percentage of obese patients and those with previous surgeries changed in laparoscopic hysterectomy cases over time?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hysterectomy is to discuss the possibility of laparoscopic hysterectomy as a minimally invasive option, even if the patient has challenging factors such as obesity, previous abdominal surgeries, or a large uterus. Advancements in technology and surgical techniques have made laparoscopic hysterectomy a viable option for many patients, even in challenging cases. It is important to have a thorough discussion with your doctor about the different hysterectomy options available and how they may be suitable for your specific situation.

Suitable For

Patients who are typically recommended for hysterectomy include those with benign gynecological conditions such as fibroids, endometriosis, adenomyosis, abnormal uterine bleeding, pelvic organ prolapse, and chronic pelvic pain. Additionally, patients with certain types of gynecological cancers, such as uterine, cervical, or ovarian cancer, may also be recommended for hysterectomy as part of their treatment plan. Other factors that may influence the recommendation for hysterectomy include the patient’s age, overall health status, desire for future fertility, and the severity of their symptoms or condition.

Timeline

Before hysterectomy:

  • Patient may have been experiencing symptoms such as heavy menstrual bleeding, pelvic pain, or fibroids
  • Patient consults with gynecologist to discuss treatment options, including hysterectomy
  • Patient undergoes pre-operative testing and evaluation to determine candidacy for surgery
  • Patient may receive counseling on the potential risks and benefits of hysterectomy

After hysterectomy:

  • Patient undergoes surgery to remove the uterus
  • Patient may experience pain and discomfort in the immediate post-operative period
  • Patient stays in the hospital for a few days for monitoring and recovery
  • Patient may experience changes in hormone levels and emotions after surgery
  • Patient follows up with gynecologist for post-operative care and monitoring
  • Patient may experience relief from symptoms that led to the hysterectomy

What to Ask Your Doctor

Some questions a patient should ask their doctor about hysterectomy include:

  1. Is laparoscopic hysterectomy an option for me, and what are the potential benefits compared to other types of hysterectomy?
  2. How does obesity, previous abdominal surgeries, and the size of my uterus affect the feasibility of laparoscopic hysterectomy in my case?
  3. What are the potential risks and complications associated with laparoscopic hysterectomy, especially considering any challenging factors in my medical history?
  4. What is the recovery process like for laparoscopic hysterectomy, and how long can I expect to be off work or restricted in my daily activities?
  5. Are there any alternative treatments or procedures that may be more suitable for me based on my individual circumstances?
  6. How experienced is the surgical team in performing laparoscopic hysterectomies, particularly in challenging cases like mine?
  7. What is the long-term outlook for my health and well-being after undergoing a laparoscopic hysterectomy, especially considering any factors that may impact my recovery or overall outcome?

Reference

Authors: Orhan A, Ozerkan K, Kasapoglu I, Ocakoglu G, Cetinkaya Demir B, Gunaydin T, Uncu G. Journal: J Gynecol Obstet Hum Reprod. 2019 Dec;48(10):791-798. doi: 10.1016/j.jogoh.2019.06.007. Epub 2019 Jul 26. PMID: 31356889