Dangers of Laparoscopic Surgery vs. Hysterectomies
>> Thursday, September 11, 2014
Many women have hysterectomies for various reasons like heavy bleeding, endometriosis, extreme pelvic pain, fibroids tumors, adenomyosis, and endometrial cancer. Uterine cancer, adenomyosis and uterine fibroids can cause the uterus to abnormally enlarge.
A hysterectomy is a major surgery and requires many weeks of recovery. Of course, many women work outside the home and some are the primary income providers, so taking too much time off to recover from surgery can be a big deal.
So there has been a push towards expansion of minimally invasive surgeries like laparoscopic and robotic techniques. This advance in technology has brought forth many devices quickly and the controversy behind some devices for gynecologic procedures has intensified. Some devices were designed to remove fibroids and large uteruses through a laparoscopic incision by grinding it into small pieces. Prior to these devices, there was no way to do this except through a traditional vertical or horizontal incision. The thinking was that, with smaller incisions and laparoscopic procedures, women could heal faster and spend less time in the hospital.
New technology is hard to resist - patients demand it from their doctors, and many doctors use it to promote their practices and increase business. Many times this enthusiasm from both sides creates short cuts in pre-operative evaluations, pushing aside the traditional protocols. These protocols were set in place to ensure patient safety during operative procedures. But even with a thorough pre-operative evaluation small or hidden cancers can be missed.
We even see huge billboards advertising procedures for fibroids or enlarged uterus removal. They may show a picture of a woman's tummy with a very long incision from the ribs down past the belly-button and stopping at the pubic bone. No one would want that if they can have same surgery done with only three or four 1-2 inch incisions. I sure wouldn't. But the truth is, we rarely use vertical incisions because most of these surgeries can be accomplished with the horizontal "Bikini Cut" incision called a pfanensteil incision.
The new devices are made to fit through the small laparoscopic incisions. With the help of an assistant to hold the fibroid or uterus through one laparoscopic incision, the device is placed through a second incision. It is then placed directly on the fibroid or uterus and can then be turned on to grind the tissue until all the fibroids or the entire uterus is removed.
Just as quickly as it rose in popularity, it's popularity fell away. This happened because it became the focus of many serious complications. During the procedure, many undetected cancers were reported to be found. Once opened and ground up, cancerous tissue can spill into the abdomen and pelvis, resulting in the spread and rapid advancement of the cancer. Manufacturers have recalled devices from hospitals and surgery centers.
We all love technology, as it can make our life so much easier, and hopefully we will see a return of a similar, but much safer, type of device.
A hysterectomy is a major surgery and requires many weeks of recovery. Of course, many women work outside the home and some are the primary income providers, so taking too much time off to recover from surgery can be a big deal.
So there has been a push towards expansion of minimally invasive surgeries like laparoscopic and robotic techniques. This advance in technology has brought forth many devices quickly and the controversy behind some devices for gynecologic procedures has intensified. Some devices were designed to remove fibroids and large uteruses through a laparoscopic incision by grinding it into small pieces. Prior to these devices, there was no way to do this except through a traditional vertical or horizontal incision. The thinking was that, with smaller incisions and laparoscopic procedures, women could heal faster and spend less time in the hospital.
New technology is hard to resist - patients demand it from their doctors, and many doctors use it to promote their practices and increase business. Many times this enthusiasm from both sides creates short cuts in pre-operative evaluations, pushing aside the traditional protocols. These protocols were set in place to ensure patient safety during operative procedures. But even with a thorough pre-operative evaluation small or hidden cancers can be missed.
We even see huge billboards advertising procedures for fibroids or enlarged uterus removal. They may show a picture of a woman's tummy with a very long incision from the ribs down past the belly-button and stopping at the pubic bone. No one would want that if they can have same surgery done with only three or four 1-2 inch incisions. I sure wouldn't. But the truth is, we rarely use vertical incisions because most of these surgeries can be accomplished with the horizontal "Bikini Cut" incision called a pfanensteil incision.
The new devices are made to fit through the small laparoscopic incisions. With the help of an assistant to hold the fibroid or uterus through one laparoscopic incision, the device is placed through a second incision. It is then placed directly on the fibroid or uterus and can then be turned on to grind the tissue until all the fibroids or the entire uterus is removed.
Just as quickly as it rose in popularity, it's popularity fell away. This happened because it became the focus of many serious complications. During the procedure, many undetected cancers were reported to be found. Once opened and ground up, cancerous tissue can spill into the abdomen and pelvis, resulting in the spread and rapid advancement of the cancer. Manufacturers have recalled devices from hospitals and surgery centers.
We all love technology, as it can make our life so much easier, and hopefully we will see a return of a similar, but much safer, type of device.
