January 15, 2017 Liza Colimon, MD If your fibroids, endometriosis, heavy menstrual periods or chronic pelvic pain have led you to considering a hysterectomy, be your best advocate... Likely you are a candidate for minimally invasive surgery. There are many reasons why women choose to undergo a hysterectomy procedure. Approximately 600,000 hysterectomy procedures are performed every year in the United States. It is the second most common gynecologic surgery trailing cesarean deliveries. Many women opt for definitive management via hysterectomy to improve their quality of life. If you are considering a hysterectomy procedure it is imperative that you understand the procedure as well as your options and alternatives. A Total Hysterectomy is defined as the surgical removal of the uterus and uterine cervix. In a Supracervical Hysterectomy the uterus is removed but the cervix is spared. A hysterectomy does not involve removing the ovaries or fallopian tubes. Many myths have led women to believe that removing the uterus "will change my life for the worse." Women also believe that the hysterectomy procedure will change their sex life. However, if the ovaries are spared, you will also be spared many of the challenges of undergoing an immediate surgical menopause. If the ovaries and tubes need to be removed this procedure is called a Salpingo-Oophorectomy and depending on your age and menstrual status, may cause menopausal symptoms such as hot flashes, decreased libido, difficulty sleeping or concentrating. We can often use hormone replacement to make your transition more comfortable. However, in most cases, the ovaries and fallopian tubes are spared. Also women often report an improvement in their quality of life after the procedure because they no longer have to suffer through painful periods, heavy bleeding, irregular bleeding, or chronic pain. Once you are considering a hysterectomy or have been strongly advised to undergo the procedure, you must familiarize yourself with your surgical options to optimize your recovery, minimize pain, and facilitate your immediate return to your lifestyle. Vaginal, Laparoscopic, and Robotic-assisted hysterectomy procedures are minimally invasive options to the traditional abdominal approach that requires a larger incision. Vaginal hysterectomy is considered the least invasive option for performing a total hysterectomy because the entire uterus and cervix can be removed through the vagina without abdominal incisions IF you are a good candidate. If you have large fibroids, an extensive surgical history, chronic pelvic pain, or a cesarean section history then your best option would likely be a laparoscopic or robotic-assisted approach utilizing the da@Vinci Surgical System. Both of these procedures are minimally invasive utilizing small incisions ranging from 0.5-1 cm on the abdominal wall. The incisions then accommodate small instruments which are placed directly inside your abdomen to perform the surgery. The benefits are endless... shorter hospital stay, less pain, minimal scarring, shorter recovery time... and most of all, a happier you!