It may sound impossible, but with new robotic technology surgeons can now completely remove a woman’s uterus (called a hysterectomy) while leaving no visible scar. The future of gynecologic surgery means less pain, better outcomes and reduced risk of complications, says Nathan Mordel, M.D., a gynecologic surgeon and urogynecologist at Piedmont Atlanta Hospital.
A history of the hysterectomy
Traditional hysterectomy
The traditional hysterectomy, which has been performed for more than 100 years, required an incision either across or down a woman’s abdomen. The incision was several inches long and cut through six layers of body tissue. This meant a longer hospital stay, months of recuperation, and an increased risk of infection and hernias. Scarring was inevitable.
Vaginal hysterectomy
As surgical techniques advanced, the vaginal hysterectomy became another option for removing the uterus. However, vaginal hysterectomy is limited to only certain cases and isn’t appropriate for all women, says Dr. Mordel.
Laparoscopic hysterectomy
This minimally-invasive surgery allowed surgeons to remove the uterus through several small incisions in the abdomen. The downside of this procedure is that it only offers surgeons a two-dimensional view inside the body and a limited range of motion.
The benefits of robot-assisted hysterectomy
“We essentially did a miracle,” says Dr. Mordel. “The convenience of open surgery was translated into small-incision surgery.”
The benefits of robot-assisted hysterectomy include:
1. Better vision for surgeons. Robotic surgery provides surgeons with three-dimensional vision so they can see exactly what they would see during an open surgery.
2. More control over instruments. During laparoscopic surgery, surgeons have to choose whether to use an instrument in both hands and have someone else guide the camera, or use only one instrument and have a camera in their other hand.
“With robotic surgery, I can drive the camera and two instruments at the same time,” explains Dr. Mordel. “
3. More flexible and versatile instruments, providing better access to different areas inside the abdomen.
Single-site robot-assisted hysterectomy
Single-site surgery means that instead of the traditional four incisions used in minimally-invasive laparoscopic surgery, which range from half an inch to one inch in size, the only incision required is a one-inch opening in the belly button.
Dr. Mordel is the only “benign” gynecologic surgeon in Georgia who can perform robotically-assisted single-site (or “scarless”) hysterectomies.
“Less incisions means less chance that it’ll become infected and less chance that you’ll develop a hernia or pain in those incisions,” he says. “The final result is as if [a woman] never had surgery because we know how to hide the incision inside the belly button.”
To learn more about hysterectomy and other medical procedures, visit Piedmont Women’s Services.
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