When less invasive alternatives have failed or no minimally invasive alternative is available, more extensive surgery may be required. Hysterectomy may be performed vaginally, laparoscopically, robotically, or via traditional abdominal laparotomy (vertical or transverse abdominal incision).
Vaginal hysterectomy is the least invasive procedure.
Robotic hysterectomy affords several advantages for the surgeon, including less fatigue. But, it has been shown to improve outcomes only for certain gynecologic conditions (including extreme obesity and endometrial cancer).
Laparoscopic and robotic hysterectomies have equivalent risks and recovery times when used to treat other gynecologic diagnoses (such as fibroids).
Open abdominal hysterectomies may be required in select patients because of severe adhesive disease or very large uterine size. ANY hysterectomy may require conversion to an open technique because of unanticipated intraoperative complications.
The infrequent need for hysterectomy in current gynecologic practice results in physicians’ decreased ability to perform enough surgeries to maintain the technical skills required to perform surgery with the best outcomes and fewest complications. Because hysterectomies are now seldom required to treat gynecologic problems, Drs. Perry and Wagaman have decided to limit their cases and refer most patients requiring hysterectomy to physicians who are skilled in complicated procedures and who perform high volumes of major surgery.
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If a hysterectomy is recommended by our physicians, it is certain that all other options have been explored or exhausted and that the surgeon performing the procedure will be extremely skilled and able to carry out the surgery in the least invasive fashion possible with the lowest risk for complications.