One Incision, No Scar:
Surgeons Use Robot to Perform Hysterectomy through a Single, Small Cut in the Belly Button
TUPELO, Miss.—Many women say life starts at 40. Amber McHenry of Saltillo wouldn’t disagree.
McHenry had a history of heavy periods dating back to high school, but they got much worse with age and after having four children. By the time she reached 39, she was experiencing heavy cycles every two weeks. “I had a lot of pain. I was very tired and had no energy,” she says.
All of McHenry’s children play competitive sports, and the family spends a great deal of time traveling for swim meets, gymnastics competitions and more. “We went to Disney last September, and I was so tired from all that walking around,” she says.
McHenry could also tell a big difference between two half-marathons she ran five years apart. “In 2010 I finished my half-marathon in good time,” she says. “But last year I ran a half-marathon, and it was all I could do to finish that race. It felt like lead in my feet.” McHenry says she knew it was time to do something.
Cassie Hill, M.D., a board-certified obstetrician-gynecologist with Sanders Clinic for Women, gave McHenry the option of endometrial ablation, a procedure that surgically destroys the lining of the uterus to reduce menstrual flow, or hysterectomy, surgical removal of the uterus that often includes the fallopian tubes and/or ovaries. Hysterectomy can be done vaginally, as an open procedure or as minimally-invasive surgery—either traditional laparoscopy or robotically-assisted surgery.
She opted for hysterectomy and was pleased to learn that Dr. Hill and other ob-gyns at the NMMC Women’s Hospital in Tupelo now perform what’s called single-site robot-assisted surgery. “We make one single incision in the belly button, that’s hidden,” Dr. Hill says. “This procedure offers all the benefits of traditional laparoscopy and robotic surgery—it’s outpatient, has minimal pain and a quicker recovery—plus there is virtually no scar.”
The da Vinci robot allows physicians to do a laparoscopic hysterectomy with high definition images, giving the surgeon a three-dimensional view of the operating field and the ability to zoom in and out. The robot’s instrumentation offers surgeons flexibility beyond the limitations of their own hands, allowing them to perform even difficult cases using a laparoscopic approach.
In the original robotic-assisted procedure, the surgeon performs complex surgical maneuvers through four 8-millimeter ports (small punctures). The single-site procedure is similar, but uses different instrumentation and requires only one 2.5- to 3-centimeter incision that is hidden in the woman’s belly button. “The instruments are smaller and more flexible,” Dr. Hill says.
The majority of hysterectomies performed at the NMMC Women’s Hospital are now done robotically, she says. Patients typically have less pain, less blood loss, less scarring, and often better clinical outcomes.
McHenry went home the afternoon of surgery with only a small antibiotic-coated bandage on her belly button. “I was up walking around even before I left the hospital,” she says. “It was not bad at all. The recovery time was fabulous.”
McHenry says she took it easy for a week but after two weeks felt much better. “After four weeks I was able to start back walking for exercise,” she says. After almost eight weeks she was released to return to normal activities, including running and frequent workouts.
Ob-gyn Eric Webb, M.D., who performed the first robotically-assisted hysterectomy at NMMC in 2008 and now also offers the single-site procedure, says it is another step on the continuum of newer technology. “From multi-port to single-port is an evolution from where we were,” he says. “It represents incremental improvements in less-invasive surgery that offers superior results with less pain and suffering.”
Webb is also impressed with the “almost invisible” incision. “This procedure offers a better cosmetic outcome without compromising the quality of care,” he says.
For McHenry, the virtually scar-free procedure offered much more than aesthetic appeal. “My quality of life was greatly improved,” she says. “I feel like a different person…. I feel great! It is one of best things I have ever done.”
For more information about robotic surgery, visit www.nmhs.net/robotic_surgery.php or call 1- 800-THE DESK (1-800-843-3375).
Surgery beyond the Limits of the Human Hand
NMMC is now home to four da Vinci robots—two at Women’s Hospital and two at the main hospital. Some of the most common robotic surgery procedures at NMMC include:
- Endometriosis resection
- Myomectomy (surgical removal of uterine fibroids)
- Oophorectomy (surgical removal of the ovaries)
- Colpopexy (pelvic floor repair)
- Adrenalectomy (removal of adrenal glands)
- Nephrectomy (kidney surgery)
- Cystectomy (bladder surgery)
- Pyeloplasty (reconstructive surgery of the kidney/ureter)
- Hernia (numerous types)
- Gastric surgery