Scarless Hysterectomy Breakthrough

Single-site hysterectomy yields quicker recovery and cosmetic result

When Jane Brousseau was told by her doctor that she was a prime candidate for scarless hysterectomy, she wanted to try it. The minimally invasive treatment, now offered by Inova Women’s Hospital at Inova Fairfax Medical Campus, involves a short recovery and leaves a nearly invisible scar. Given Brousseau’s active lifestyle, the 71-year-old grandmother wanted a procedure that would get her back to swimming and walking as quickly as possible. And the fact that the procedure is cosmetically appealing was an added bonus.

“I have to look in a mirror to see it,” says Brousseau. “It’s incredible. And it’s also incredible that I came home the same day of my procedure.”

Good Choice

Brousseau went to see Ruchi Garg, MD, a gynecologic oncologist at Inova Women’s Hospital, when she was experiencing abnormal vaginal bleeding. Dr. Garg recommended that Brousseau have a robotically assisted single-site hysterectomy, which is performed through a tiny incision at the base of the belly button. The entire procedure would leave an almost imperceptible scar less than an inch long. “The advantage of robot-assisted single-site surgery over traditional laparoscopy is just that there’s no visible scar,” says Dr. Garg. “And the advantages over open surgery include quicker recovery with early return to home, minimal blood loss, decreased  rate of infection and quicker return to work and normal activity.”

Scott Rose, MD, a gynecologic oncologist who also performs the surgery at Inova Women’s Hospital, explains that recovery is fast because the navel is not a particularly tender area. “Making a small incision through there cuts down on postoperative pain,” he says. “Also, because all instrumentation is placed in the abdomen only once, patients don’t have a lot of manipulation of the incision. That contributes to less postoperative pain.”

Dr. Rose and Dr. Garg, along with their partners, Annette Bicher, MD, and John Elkas, MD, perform a wide range of minimally invasive surgeries. Dr. Rose has been designated by Intuitive Surgical Inc., the maker of the da Vinci Surgical System, as one  of only a few surgeons in the United States who can instruct other surgeons in single-site robotics surgery for gynecology.

“We’re certainly excited about any surgical procedure that  we give to a patient that makes it less invasive with less recovery time,” he says.

 Maximum Precision

During single-site surgery, the surgeon sits at a computer console displaying a magnified three-dimensional image of the surgical site. The surgeon uses controls to precisely  guide tiny surgical instruments and a camera through a small port in the navel. The procedure can be performed in about an hour, and the patient usually goes home  the same day or the next day following surgery.

Several of Brousseau’s friends had experienced robotic surgery and were very happy with the procedure so she was familiar with what to expect.

“It’s kind of an easy surgery to recover from, and Dr. Garg  was very good about explaining every aspect,” says Brousseau.

“The procedure was great,” she adds. “I left the hospital the same day and didn’t need any pain medication. My recovery  went very quickly, and in two weeks I went back to see Dr. Garg and everything was fine.”

Leading Edge

Inova Women’s Hospital is committed to providing women with the most advanced gynecologic procedures available. The Food and Drug Administration recently approved single-site hysterectomy. Dr. Garg and Dr. Rose, who have been performing it since August, are thrilled about the procedure’s potential.

“The general surgeons at the hospital have been performing single-site gallbladder surgery for about two years now, and now that the procedure is approved by the FDA for hysterectomy, we are excited to offer this procedure to our patients,” says Dr. Garg.

“We are some of the only people in Northern Virginia performing this procedure,” adds Dr. Rose.

For Brousseau, who wanted to get back to her activities soon after surgery, the procedure was a welcome option. Just six weeks after the surgery, Brousseau was back to swimming, taking long walks and traveling to see her grandchildren.

“Dr. Garg selected the right surgery for me,” she says.

Experience Counts

If your doctor recommends a hysterectomy and you want your recovery to be as short as possible, you may be a candidate for minimally invasive surgery. At Inova Women’s Hospital, most hysterectomies are performed minimally invasively, using both traditional laparoscopic and robotic surgical techniques. Less invasive procedures result in better outcomes, quicker recovery, less time in the hospital and a higher level of patient satisfaction, say Dr. Garg and Dr. Rose.

“Minimally invasive surgery, whether it is with a robot or not, provides a faster recovery,” notes Dr. Rose. “Minimally invasive implies  a minimal number of small  incisions, and in each case,  it’s a minimal recovery time.”

The gynecology team has the experience to make your surgical outcome the best it can be.  U.S. News & World Report ranked Inova Women’s Hospital 19th in the nation in Gynecology — the region’s only hospital to be nationally recognized.  Learn more at inova.org/womens.

 

High-Tech Gallbladder Surgery

Hysterectomy is not the only single-site procedure being performed at Inova. John Moynihan, MD, Chairman of the Department of Surgery at Inova Fairfax Medical Campus, conducts robotically assisted cholecystectomy (gallbladder removal).

“There are a number of benefits to the minimally invasive approach to cholecystectomy including a low rate of major complications, virtually scarless results, minimal pain and overall increased patient satisfaction,” he says.

This innovative approach, which received FDA clearance in December 2011, features a magnified 3-D, high-definition vision system coupled with new instrumentation, allowing surgeons to operate with enhanced vision and precision. Dr. Moynihan is a leader in the field of minimally invasive gallbladder surgery.

“I was fortunate to perform the first laparoscopic cholecystectomy at Inova Fairfax Hospital in 1990 and have been an advocate of the advancement of techniques that promote improved patient outcomes and with shorter hospital stays and increased patient satisfaction, since minimally invasive approaches to surgical conditions expanded our ability to care for our patients,” he says.