Our Summary

This study compared two types of minimally invasive surgeries used to remove the uterus (hysterectomy) in cancer patients. The first type is the conventional laparoscopic hysterectomy (CLH) which uses several small cuts to insert surgical instruments, while the second is single-incision laparoscopic hysterectomy (SILH) which uses only one cut.

The researchers found that both methods are equally effective in terms of blood loss, time spent in the hospital, and the rate of complications. However, the SILH method takes a bit longer to perform, puts more workload on the surgeon, and can cause slightly more pain for the patient after the surgery.

In other words, while the single-incision method might seem better because it uses only one cut, it has its own disadvantages compared to the conventional multi-cut method.

FAQs

  1. What are the two types of minimally invasive surgeries for hysterectomy discussed in the study?
  2. How do the outcomes of conventional laparoscopic hysterectomy and single-incision laparoscopic hysterectomy compare?
  3. What are some disadvantages of the single-incision laparoscopic hysterectomy method as mentioned in the study?

Doctor’s Tip

A doctor might tell a patient considering a laparoscopic hysterectomy that both the conventional laparoscopic hysterectomy and single-incision laparoscopic hysterectomy are effective options, but the single-incision method may have some drawbacks such as longer surgery time, increased surgeon workload, and potentially more post-operative pain. It’s important for the patient to discuss the pros and cons of each method with their doctor to determine which option is best for their individual situation.

Suitable For

Patients who are typically recommended for laparoscopic hysterectomy include those with benign conditions such as fibroids, endometriosis, or abnormal bleeding, as well as those with early-stage gynecologic cancers such as uterine, cervical, or ovarian cancer. The choice between CLH and SILH will depend on the specific circumstances of the patient and the surgeon’s expertise with each method.

Timeline

Before the laparoscopic hysterectomy:

  1. Patient consults with their gynecologist or surgeon to discuss the need for a hysterectomy and the different surgical options available.
  2. Patient undergoes pre-operative testing such as blood work, imaging scans, and possibly a pelvic exam.
  3. Patient may be instructed to stop taking certain medications or to follow a specific diet before the surgery.
  4. Patient is given instructions on what to expect during and after the surgery, as well as how to prepare for the recovery period.

After the laparoscopic hysterectomy:

  1. Patient is monitored closely in the recovery room for any immediate complications.
  2. Patient may experience some pain, discomfort, and bloating in the days following the surgery.
  3. Patient is encouraged to walk around and perform light activities to aid in the recovery process.
  4. Patient is given instructions on how to care for the incision sites and manage any post-operative pain.
  5. Patient follows up with their surgeon for a post-operative appointment to assess their recovery progress and discuss any concerns.
  6. Patient gradually resumes normal activities and may be advised to avoid heavy lifting or strenuous exercise for a certain period of time.
  7. Patient may experience improvements in their symptoms related to the condition that necessitated the hysterectomy, such as pelvic pain or abnormal bleeding.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with both conventional laparoscopic hysterectomy and single-incision laparoscopic hysterectomy?
  2. How experienced are you in performing each type of laparoscopic hysterectomy?
  3. How long will the surgery take for each method, and what is the expected recovery time?
  4. Will I have a choice in which method is used for my surgery, and if so, what factors should I consider when making that decision?
  5. What type of pain management options are available for each method, and how can I best prepare for post-operative pain?
  6. Will there be any scarring or long-term effects from either type of laparoscopic hysterectomy?
  7. How likely is it that I will need further surgeries or treatments after the hysterectomy, regardless of the method used?
  8. Are there any specific lifestyle changes or precautions I should take following the surgery, and are there any activities I should avoid during the recovery period?
  9. Are there any alternative treatment options to hysterectomy that I should consider before making a decision?

Reference

Authors: Fathi A, Saleh MM, Shetiwy M, Elzahaby IA, Farouk O, Shams N, Elghandour MF, Abouzid A. Journal: Surg Innov. 2022 Oct;29(5):590-599. doi: 10.1177/15533506211041892. Epub 2021 Sep 1. PMID: 34465254