Hysterectomy | The Center for Innovative GYN Care

Laparoscopic Hysterectomy (Standard)

This standard procedure uses between three and five incisions, ranging in size from 5 to 15 mm. This conventional approach to laparoscopic hysterectomy is used by laparoscopic specialists and OBGYN surgeons. Standard conventional laparoscopy is preferred to robotics or open procedures. The incisions are smaller and the recovery can be faster. Standard conventional laparoscopy does not use retroperitoneal dissection techniques, and can be limited in the extent of surgery performed. It is important to understand that not all surgeons performing this technique have the same skills or experience.The results with conventional laparoscopy depend on the training and focus of the surgeon doing the procedure.

Robotic techniques have recently been applied to benign GYN surgery with some controversy. In general, robotic procedures enable an OBGYN not well trained or comfortable with DualPortGYN, retroperitoneal, or conventional laparoscopy to complete a hysterectomy through a minimally invasive approach.

In fact, all minimally invasive procedures are not the same. According to the American Association of Gynecologic Laparoscopists (AAGL), robotic-assisted laparoscopic surgery should not replace conventional laparoscopic or vaginal procedures for women who could otherwise undergo conventional laparoscopic or vaginal surgery for benign gynecological diseases.

Robotic hysterectomies use up to five incisions located throughout the pelvic and abdominal cavity, often placed through the abdominal wall musculature. This means the incisions are often located above the belly button to the right and left sides of the abdomen. The size of the incisions is larger, and range between 8 mm and 1.5 cm, totaling up to 50 mm in length. Single site robotic approaches use one larger incision at the umbilicus (belly button) for surgery. This incision can be much larger than even standard laparoscopy, and the procedure itself has significant limitations for the removal of more complex cases or larger uteri. There is also a higher herniation rate with single site procedures, in which the bowel can herniate through the abdominal wall. As a comparison, DualPortGYN procedures use only two incisions at 5 mm each to perform the exact same procedure. The total incision length for DualPortGYN is 10 mm, 1/5 the size of the standard robotic approach, and 1/3 or less the size of single site.

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Hysterectomy | The Center for Innovative GYN Care

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