Welsch, Christopher T. M.D.


Welsch, Christopher T. M.D.

Minimally Invasive Surgery

For those women who do not receive relief from - or are not candidates for - management of abnormal menstrual cycles with medication, surgical procedures provide additional options for the management of these disorders. If a patient chooses definitive surgery as her best choice for long-term relief, the abdominal hysterectomy has traditionally been the most commonly used approach for removal of the uterus. Unfortunately, open abdominal surgery can be associated with a hospital stay of two to three days or more and up to six to eight weeks to recover… time away from work and family that many individuals cannot spare. “Minimally invasive” surgical approaches can provide a woman with relief of her symptoms, and allow her to return to normal activity much more quickly.

Three types of hysterectomy are considered “minimally invasive” and may be associated with more rapid recovery – vaginal, laparoscopic and robotic assisted.

With vaginal hysterectomy, the uterus is completely removed through the vagina, usually with no abdominal incisions. Most patients can go home the day after surgery and can be back to work in four weeks. The surgery is performed without actually seeing inside the abdominal cavity and some conditions may make vaginal hysterectomy more difficult or even impossible to perform, such as a very enlarged uterus, the presence of scar tissue, or previous operations. Sometime a surgery is begun through the vagina but has to be completed through an abdominal incision, like a standard abdominal hysterectomy.

Laparoscopy is a surgery where the doctor inserts a telescope and instruments through small incisions (about the width of a finger) in the abdominal wall. A surgeon can see more clearly with this approach as he is viewing the pelvic organs directly on a large TV screen. A patient having hysterectomy performed by laparoscopy can potentially go home the same day and be back to work in one to two weeks.

Robotic assisted (da Vinci) surgery is the next generation of laparoscopy, where a surgery is performed through small incisions on the abdomen but the surgeon has a three dimensional, high definition view of the area where he is operating. The doctor then controls small instruments that exactly mimic the movements of his hands to complete the procedure. The robot does not perform the surgery, but is used by the surgeon to operate with increased precision and safety. Patients undergoing da Vinci surgery may experience up to a 90% decrease in complications and up to 2/3 less blood loss over other types of minimally invasive surgery, in addition to a lower chance of having to convert to abdominal hysterectomy. They can go home the same day and return to work in one to two weeks.

There are many causes of abnormal uterine bleeding. If a woman experiences any of the following, consultation with a gynecologist is recommended

• Menstrual flow longer than seven days

• Bleeding more than once a month or in between cycles

• Passing clots, flooding, or staining clothes or bed sheets

• Anemia (low blood counts)

The Department of Obstetrics and Gynecology The Jackson Clinic is the regions leader in minimally invasive gynecologic surgery. Their gynecologists have completed over 1500 robotic procedures, have performed additional thousands of minimally invasive surgeries for gynecologic conditions, and represent over 100 years of surgical experience and commitment to excellence in patient care. They are the first group in Jackson to offer robotic hysterectomy for the treatment of abnormal bleeding, and are the only group with da Vinci certified instructors for robotic gynecologic surgery. Gynecologists at The Jackson Clinic are the only physicians in Jackson to offer robotic sacral colpopexy - the gold standard for treatment of certain types of pelvic organ relaxation – and da Vinci single-incision hysterectomy.

If you would like more information, contact me or any of our OB/GYN team at The Jackson Clinic 731-422-0213 or www.jacksonclinic.com