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Single Hole Surgery -
Scarless Surgery
You thought that a Surgery, even keyhole,
always produces a scar. Not any
more!
Uterus Surgery
(Hysterectomy)
Gall
Bladder /
Appendix/
Hernia,
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What is Hysterectomy (Uterus removal)?
A
hysterectomy
is the removal of the
uterus
(womb). Sometimes, the
Fallopian tubes
and
ovaries
are also removed, which is called Salpingo-oophrectomy. (
Salpingectomy= removal of fallopian tube, Oophrectomy=
removal of ovary).
What are the common reasons for doing a
Hysterectomy?
The common reasons for doing a hysterectomy are
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1.
Fibroids-Benign tumors of the uterus (30% )
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2.
Abnormal
Bleeding from uterus(20%)
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3.
Endometriosis
(20%)
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4.
Genital
prolapse (15%)
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5.
Chronic
pelvic pain (10%)
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6.
Miscellaneous (5%).
Uterine cancer
is an uncommon, but important reason for doing a
hysterectomy.
Are there different types and ways of doing
Hysterectomy? If yes, how many?
Total hysterectomy The uterus and the cervix are removed.
Subtotal or partial hysterectomy
The upper portion of the uterus is removed, leaving the
cervix intact. Usually done in cases where it’s difficult
to remove cervix.
Hysterectomy with Salpingo-oophrectomy-
The uterus, cervix, fallopian tube and ovary is removed.
Radical hysterectomy The uterus, cervix and ovaries are removed. The surgery
is more extensive with removal of surrounding tissues and
lymph nodes. Done in cases of cancer.
Depending upon the extent and invasiveness of operation,
there are several ways the surgery can be
performed:
Abdominal Hysterectomy
This hysterectomy is performed using an incision in the
abdomen (tummy) that can be either vertical from the area
of the pubic bone up toward the belly button (navel), or
it may be horizontal along the bikini line. The uterus is
taken out through the abdomen incision.
Vaginal Hysterectomy This hysterectomy is performed entirely through an
incision made in the vagina. This is usually possible in
cases of Prolapse uterus (attachments of uterus become lax
and uterus starts protruding out through the vaginal
outlet).
Laparoscopic Assisted Hysterectomy
This is the hysterectomy done by Laparoscopic (keyhole)
method and the uterus is taken out through the vaginal
route.
Total Laparoscopic Hysterectomy
In this laparoscopic method, the uterus is taken out
through the abdominal holes (small incisions) after
morcellation (cutting uterus in small pieces).
Single Incision Laparoscopic Hysterectomy or Scarless
Hysterectomy In
this latest laparoscopic method, the surgery is done
through a small single hole (incision) done through the
belly button (navel). As the scar is inside the navel,
it’s not visible after the operation making it virtually a
‘scarless’ operation.
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What are the advantages of laparoscopic hysterectomy (Uterus
removal)? |
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 The
advantages over the conventional hysterectomy are
that there is minimal tissue handling resulting in
much less pain and lesser chances of adhesion
formation after the operation. 3-4 small incisions
of 0.5-1.0 cm (as compared to 10-15cms in
conventional procedure) are given on the abdomen
resulting in less blood loss and lesser chances of
wound infection with decreased hospital stay and
early recovery as compared to conventional
surgery. |
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What is Single Hole {Scarless} Laparoscopic
Hysterectomy (Uterus removal)?
In Single Hole Surgery, the
complete surgery is done through a single small
puncture/hole/incision of about 1.5 to 2.5 cms.
This small cut is made inside the navel
(umbilicus) in such a way that the scar is
practically invisible after the operation, making
it a scarless surgery.
What is the advantages of
Single Hole Laparoscopic Hysterectomy?
As there is only one small cut (incision), the
Single Hole Surgery is associated with:-
1. Less pain
2. Early discharge from the hospital
3. Early return to work
4. Less risk of wound infection
5. Lesser risk of hernia formation as no muscle is
cut
6.Excellent cosmetic result as the operation is
virtually scarless. |
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Who can undergo Single Hole Laparoscopic
Hysterectomy?
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Usually all the patients who have been advised for
conventional hysterectomy can undergo Single Hole
laparoscopic hysterectomy, provided the size of
uterus is not very big (that is bigger than 20
cm).
A person with diabetes or hypertension can also
undergo this procedure after the conditions are
under control, and in fact the advantages of
lesser chances of infection and early recovery are
very beneficial for them.
A patient who has undergone operations in the past
can also usually undergo this procedure and if
there are adhesions because of previous
operations, they can usually be removed along with
the laparoscopic hysterectomy, in the same
sitting.
It is also possible to treat or remove the ovaries
and tubes while carrying out laparoscopic
hysterectomy. |
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What preparation is needed before the
procedure? |
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The
usual routine tests are required as for any other
operative procedure and no special investigation
is required for Single Hole hysterectomy.
To make the operation easier, the recovery after
the operation faster and resumption of normal work
or activity earlier, some medicines (laxative and
gas absorbers) along with diet restriction is
started a day before the operation. The purpose of
this is to make bowels free of gas and fecal
matter as much as possible.
After full investigations, the patient is usually
admitted a day before the operation. |
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What happens after the procedure?
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The
total hospital stay is usually for two days, after
which one can go back home.
On an average, two hours after lunch and eight
hours rest after dinner is what is usually
recommended. The patient can climb stairs slowly,
walk half to one km slowly and carry out sedentary
work at home without much difficulty. One can take
bathe usually on third to fifth day after the
operation.
Routinely, the patient is called seven days after
the operation for the removal of stitches and then
after six weeks for an internal check up. |
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When can one resume normal activity or go
back to work? |
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Once the stitches are removed, the patient can
resume normal activity like walking, jogging,
cooking, driving, sitting in front of the
computers for 4-6 hrs etc. Sexual intercourse,
strenuous exercise, lifting of heavy weights and
swimming has to be avoided for eight weeks. |
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How is woman’s sex life after
Hysterectomy?
Sex after a hysterectomy,
in many cases, is as good or better than it was before
surgery. Many women find that
they no longer have to worry about birth control or having
a period (the periods permanently stop after
hysterectomy). In ladies with pain, being pain free is
certainly an improvement.
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