(9,10) Although hysterectomy is considered the “definitive” treatment for AUB regardless of etiology, less invasive options are increasingly available, including medical therapy, the levonorgestrel intrauterine system (LNG-IUS), and endometrial ablation.
Full Answer
Should I Choose minimally invasive or conservative treatment for my hysterectomy?
The dilemma for patients and doctors in the choice between hysterectomy and minimal invasive or conservative treatment is the tradeoff between a faster recovery in minimal invasive surgery and the possibly lesser effect of the treatment.
What is the failure rate of minimal invasive hysterectomy?
It is well known from preference trials that the majority of women are willing to accept a failure rate of the minimal invasive option up to 50% in escaping a hysterectomy [25]. In the reported studies, a large proportion of patients randomized to the minimal invasive alternative treatment eventually “crossed over” to hysterectomy (25–53%).
What is the most complete hysterectomy?
Radical hysterectomy – this hysterectomy is the most complete and is usually performed in cases of uterine, cervical, or other cancer. All portions of the female reproductive system are removed, including the uterus, cervix, ovaries, fallopian tubes, upper vagina, and nearby lymph nodes.
What is the best hysterectomy procedure for fibroids?
Some conditions may require a traditional hysterectomy due to the sheer size of the uterine fibroid; other surgeons may prefer to perform the type of hysterectomy with which they are most familiar. However, in general, if all else is equal, the best hysterectomy procedure is the one that is the least invasive.
What other procedures are there besides a hysterectomy?
Alternatives to Hysterectomy: Myomectomy, Endometrial Ablation, Uterine Fibroid Embolization.
Is there a less invasive hysterectomy?
The minimally invasive approaches to hysterectomy are vaginal hysterectomy and laparoscopic hysterectomy. Before discussing these techniques we will briefly describe the abdominal hysterectomy technique. In abdominal hysterectomy, the physician will make an approximately 15 cm incision on the belly.
Is ablation safer than hysterectomy?
Hysterectomy is effective but has more complications than endometrial ablation, which is less invasive but ultimately leads to hysterectomy in 20% of women. We compared laparoscopic supracervical hysterectomy with endometrial ablation in women seeking surgical treatment for heavy menstrual bleeding.
What is better hysterectomy or hysteroscopy?
Hysteroscopic procedures appear to offer lower morbidity and a faster recovery than hysterectomy. At one year, however, satisfaction is higher for hysterectomy, presumably because it provides a more definitive cure of symptoms. Both approaches seem reasonable, and the choice should lie with the patient.
What is the easiest hysterectomy?
The American Congress of Obstetricians and Gynecologists (ACOG) says the safest, least invasive and most cost-effective way to remove a uterus for non-cancerous reasons is a vaginal hysterectomy, rather than laparoscopic or open surgery.
What are the 3 types of hysterectomy?
Hysterectomy operation The operation may be performed via an incision (cut) in your lower abdomen (abdominal hysterectomy), three to four small incisions in your abdomen (laparoscopic hysterectomy), or through your vagina (vaginal hysterectomy).
Which is better endometrial ablation or hysterectomy?
Hysterectomy was more effective than endometrial ablation in resolving bleeding but was associated with more adverse effects. By 60 months after initial treatment, 34 of the 110 women originally treated with endometrial ablation underwent a reoperation.
Who should not get endometrial ablation?
Endometrial ablation should not be done in women who are past menopause and is not recommended for those with the following medical conditions: Disorders of the uterus or endometrium. Endometrial hyperplasia. Cancer of the uterus.
Is myomectomy better than hysterectomy?
Effective Treatment for Uterine Fibroids: Myomectomy, when performed by an expert, is a safe and effective alternative to hysterectomy. The gynecologic surgeon who has extensive experience with myomectomy is able to remove fibroids. The successful myomectomy should result in resolution of symptoms related to fibroids.
What is the difference between a D&C and a hysteroscopy?
A D&C (dilatation and curettage) is a procedure where the opening of the uterus (called the cervix) is widened and the lining of the uterus is scraped away. look for growths ■ end an incomplete miscarriage. A hysteroscopy is a procedure that allows your doctor to see inside your uterus and make a diagnosis.
Is a hysteroscopy major surgery?
Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia, an overnight stay may be required.
What is the difference between laparoscopy and hysteroscopy?
Laparoscopy is performed to view and access the exterior of the uterus, ovaries, fallopian tubes and other structures within the pelvis. Hysteroscopy is performed to view the internal cavity of the uterus, identify abnormalities and perform certain corrective procedures.
What is unique about Yale Medicine's approach to minimally invasive surgery for gynecologic issues?
Our team of world-class surgeons and specialists are dedicated to providing compassionate , comprehensive care to our patients. We offer the most advanced, minimally invasive surgical techniques for the most complex cases—and the most routine.
What is hysteroscopy used for?
Hysteroscopy allows for visualization of the uterine cavity (the endometrium) without any incisions. This procedure is often performed to evaluate causes of abnormal bleeding, pain, fibroids, polyps, intrauterine scar tissue, or other structural abnormalities.
What is minimally invasive surgery?
Minimally invasive surgery is a surgical approach in which small skin incisions (less than an inch in size) and specialized tools are used to perform the surgery. This includes specialized procedures such as hysteroscopy, laparoscopy, and even robotic assisted surgery.
What are some diseases that can be corrected with laparoscopy?
Laparoscopic surgery may be appropriate for the evaluation and treatment of endometriosis, pelvic pain, scar tissue, uterine fibroids, and ovarian cysts. Laparoscopy is also a commonly utilized approach for the safe removal of the uterus ( hysterectomy) or ovaries (oophorectomy).
What is a laparoscopic camera?
The laparoscope (camera) sends live pictures to a video monitor, which allows the surgeon to visualize the anatomy and perform complex surgeries with minimal trauma to the patient . A subset of laparoscopic surgeries utilize the da Vinci Robot, a surgical tool that may be needed for certain types of surgeries.
What are the conditions that require surgery?
Some conditions that may require surgery are endometriosis, ovarian cysts, fibroids, abnormal bleeding, intrauterine scarring, damaged fallopian tubes, pelvic pain, or abnormal development of the reproductive tract.
When was robotic surgery approved?
Robotic surgery was approved for gynecological conditions in 2005 and has since opened up the option of minimally invasive surgery for women who otherwise would not have been eligible for vaginal surgery or traditional laparoscopic surgery.
What Is the Best Type of Hysterectomy?
However, in general, if all else is equal, the best hysterectomy procedure is the one that is the least invasive.
What Advantages Does vNOTES Offer Over Other Types of Hysterectomy Surgery?
As mentioned, the vNOTES procedure does not require any incisions into the patient’s abdominal cavity, instead using the vaginal opening to access the uterus or other reproductive organs.
What Conditions Lead to a Hysterectomy?
In part, hysterectomies are so common because they are a practical solution for many gynecological issues after more conservative treatments have failed. Women undergo hysterectomies to treat a variety of conditions, including (but not limited to):
What Is Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES)?
Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is an advanced gynecological technique first developed in 2012. While the traditional approaches to hysterectomy—open abdominal surgery and laparoscopic surgery—rely on making one large or
What is a vnote?
As vNOTES is a transvaginal procedure—a procedure that takes place via the vaginal opening —it allows surgical access to many of the primary and secondary organs of the female reproductive system. As a result, vNOTES can give surgeons and patients a non-invasive hysterectomy option for the treatment of uterine conditions like uterine prolapse. However, vNOTES provides a non-invasive path for use in other circumstances, as well, including the treatment and removal of uterine fibroids, abnormal bleeding, chronic pain, the removal of adnexal masses, prophylactic ovarian surgery, sterilization, cancer prevention, and more. vNOTES has been successfully employed to perform the following Ob/Gyn surgeries:
Why do you need a hysterectomy?
One of the most common reasons for hysterectomy is a cancer of one of the elements of the reproductive system. If you have uterine cancer, cervical cancer, ovarian cancer, or cancer of the fallopian tubes, your oncologist may recommend a hysterectomy.
Why do doctors recommend hysterectomy?
In many cases, physicians recommend a hysterectomy to treat severe fibroids that produce heavy, painful bleeding.