There are many alternatives available for women who want a minimally-invasive surgery for hysterectomy or myomectomy, even with a large mass, fibroid or uterus. Since 2013, we offer “enclosed tissue extraction” through small incisions in the abdomen or vagina for these types of procedures. The mass, fibroid(s), uterine body or entire uterus can be extracted while enclosed in a sturdy bag-like system that avoids the risk of contamination or spillage inside the body. These techniques are not new, and have been used for successfully extracting suspicious tissue specimens since the 1980’s. Since testing prior to surgery can help decide the relative risk of cancer or infection in a tumor or organ to be removed, “enclosed tissue extraction” can be chosen as an extra measure of safety in any case. Vaginal hysterectomy or laparoscopic vaginal hysterectomy or totally laparoscopic hysterectomy are all procedures where the entire uterus is actually physically taken out through the vagina. A “coring” technique is used in certain cases where the uterus is too large to remove this way. “Coring” keeps the uterus generally whole, but cuts it into a longer shape to allow removal.
With all of the controversy surrounding hysterectomy, fibroids and morcellation, patients need to be reassured that minimally-invasive surgery is the proven best technique using currently available methods. Laparoscopic, robotic and small-incision surgical treatment is the hands of expert gynecologists has very high success rates and very low complication rates. Large incision, “open surgery” is NOT the best method in the vast majority of cases, especially for hysterectomy and myomectomy.
