Our Summary

The researchers compared two different types of minimally invasive surgeries for removing the uterus (hysterectomy) due to benign and malignant conditions. These were percutaneous-assisted hysterectomy (PSS-H) and laparoscopic hysterectomy (LPS-H). They studied 160 patients from May 2015 to October 2017, with 80 patients receiving each type of surgery.

They found no significant differences in the basic characteristics of the patients, the time taken for the surgery, the amount of pain after the surgery, or the accuracy of the cancer treatment. However, they found that PSS-H resulted in less blood loss during surgery and fewer complications during and after surgery. They also found that patients who had PSS-H were more satisfied with the way their body looked after the surgery.

Therefore, the study concluded that PSS-H is an effective alternative to LPS-H, especially because it appears to have better cosmetic results and cause fewer complications. This suggests it could be a good option for people needing a hysterectomy due to benign conditions or low to intermediate risk endometrial cancer.

FAQs

  1. What are the two types of minimally invasive surgeries for uterus removal that the researchers compared?
  2. What were the key differences observed between percutaneous-assisted hysterectomy (PSS-H) and laparoscopic hysterectomy (LPS-H)?
  3. Based on the study, which type of surgery could be a better option for people needing a hysterectomy due to benign conditions or low to intermediate risk endometrial cancer?

Doctor’s Tip

A helpful tip a doctor might give a patient considering laparoscopic hysterectomy is to ask about the possibility of percutaneous-assisted hysterectomy as an alternative. This type of surgery may result in less blood loss and fewer complications, as well as potentially better cosmetic results. It’s important to discuss all options with your doctor to determine the best approach for your individual needs and circumstances.

Suitable For

Typically, patients recommended for laparoscopic hysterectomy are those with benign gynecological conditions such as fibroids, endometriosis, or abnormal uterine bleeding. It may also be recommended for patients with low to intermediate risk endometrial cancer. Patients who are generally healthy and have a smaller uterus are good candidates for laparoscopic hysterectomy. However, it is important for each patient to discuss their specific condition and treatment options with their healthcare provider to determine the most appropriate approach for their individual situation.

Timeline

Before Laparoscopic Hysterectomy:

  • Patient consults with their healthcare provider about the need for a hysterectomy
  • Patient undergoes pre-operative testing and evaluations to determine if they are a suitable candidate for laparoscopic hysterectomy
  • Patient may need to make lifestyle changes or take medications in preparation for surgery
  • Patient receives instructions on fasting and medication use before the surgery

During Laparoscopic Hysterectomy:

  • Patient is placed under general anesthesia
  • Surgeon makes small incisions in the abdomen and inserts a laparoscope (thin tube with a camera) to view the uterus
  • Surgeon uses specialized instruments to remove the uterus and possibly other reproductive organs
  • Surgery typically takes 1-2 hours, depending on the complexity of the case
  • Patient is monitored closely for any complications during and after the surgery

After Laparoscopic Hysterectomy:

  • Patient remains in the hospital for observation and pain management for 1-2 days
  • Patient may experience some pain, discomfort, and bloating after the surgery
  • Patient is advised to gradually resume normal activities and avoid heavy lifting for a few weeks
  • Patient may need to follow up with their healthcare provider for post-operative care and monitoring
  • Patient may experience improvements in symptoms related to their condition, such as pelvic pain, heavy bleeding, or fibroids
  • Patient may notice changes in their menstrual cycle or hormonal balance due to the removal of the uterus

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic hysterectomy compared to other types of minimally invasive surgery?

  2. How long is the recovery period after a laparoscopic hysterectomy, and what can I expect in terms of pain and discomfort during this time?

  3. Will I need to stay in the hospital after the surgery, or is it typically done on an outpatient basis?

  4. What are the potential long-term effects or implications of having a laparoscopic hysterectomy compared to other types of hysterectomy procedures?

  5. How soon can I resume normal activities, such as driving, exercising, and returning to work, after a laparoscopic hysterectomy?

  6. Are there any specific dietary or lifestyle changes I should make before or after the surgery to optimize my recovery and overall health?

  7. How will a laparoscopic hysterectomy affect my hormonal balance, menstrual cycle, and future fertility options?

  8. Are there any specific follow-up appointments or tests I will need after the surgery to monitor my recovery and ensure that there are no complications?

  9. How experienced are you in performing laparoscopic hysterectomies, and what is your success rate with this procedure?

  10. Are there any alternative treatment options or surgical approaches that I should consider before deciding on a laparoscopic hysterectomy?

Reference

Authors: Perrone E, Rossitto C, Fanfani F, Cianci S, Fagotti A, Uccella S, Vizzielli G, Vascone C, Restaino S, Fedele C, Saleh FL, Scambia G, Gueli Alletti S. Journal: Gynecol Obstet Invest. 2020;85(4):318-326. doi: 10.1159/000509877. Epub 2020 Sep 11. PMID: 32920558