SILS-how does it really work? Scared and nervous

I am scheduled for a SILS procedure on Jan. 24th, removing uterus, cervix, ovaries and tubes (I don't know all the abbreviations that you all use!). Sorry this is a long post.

I have tried to research this procedure, and get that there is a port in my belly button where they can insert instruments. I originally thought I was having the Da Vinci surgery but my surgeon said that involves multiple incisions, the SILS is only one incision.

I tried to ask her to walk me through the procedure, and she got all impatient, suggesting I didn't trust her! I tried to explain that the reason I sought her out was for her expertise, but for my own mental well-being, I just need to know how it works.

She said she goes in through the belly button and "pushes" everything out through the vagina. I can't quite grasp how that happens. I told her I viewed the da Vinci DVD she gave me and it appears that the organs are cut separately and pulled out through the vagina. She got impatient again, and said that due to my possible pre-cancerous uterus, she had to take everything out in one piece. I again asked, how is it pushed out? Don't you mean pulled? She got quite abrupt at that point, repeating, it is pushed out, I've done thousands of these. At that point, I gave up.

Maybe it's just me being a control freak, but for my piece of mind, I'd really like to understand how this procedure works. I need to visualize it. I tried watching a couple of You Tube videos on line, but they were not narrated, so I had no idea what I was watching.

Can anyone explain in layman's terms how this works? They put the port in and then what? Do they insert a camera? How do they do the cutting? How do they push it out? She says it comes out in one piece through the vagina. When I asked if it goes through the cervix, like a baby, she sneered at me (well, I assume she was sneering, this conversation was over the phone) and said no, the cervix comes out, too, it all comes out through the vagina.

I had a C-Section 21 years ago, and never had a vaginal delivery, so I don't understand how this is going to work. Not knowing is making me very stressed. Can anyone help?

Thanks!

Good questions I really didn't ask all those questions but they would be good to know. I have the diVinci method on dec 7 as far as I know my uterus,tubes and cervix were cut into there separate piece and removed thru vagina. I kept my ovaries for hormonal support and I am hoping to get at least 15 more years out of them. Lol. I would guess they keep each piece whole for diagnosis reasons and for the precancerous precautions too? But who knows. I have 5 very small incisions across my stomach above my belly button I am disappointed they r gonna leave a scar but my bikini days are about over anyway.

Good luck to you and recovery! I hope you get the answers you need. Maybe a second opinion would help? Just a thought.

Hi Doodle!

I wish I had answers for you. I'm just here to cheer you on and offer my opinion that I don't think you're a control freak or anything like that for wanting to know exactly what is going to be happening during this procedure. Doctors are human and some of them just don't have the people skills/bedside manner we'd like them to have! She may have been more helpful in person, so she could illustrate more for you -- who knows? A second opinion could be an option if moving the date out is also an option, I'm thinking. This is a major event in your life -- you need to feel comfortable and confident in the steps you're taking to get there.

I hope you get your answers and keep us posted on how it's all going for you!

Doodleowner55,

You got me wondering about the SILS hyster too so I found a video in the HysterSister collection. It is VERY GRAPHIC and not everyone will want to watch it, it is an actual surgery removing the uterus through the vagina like you and your Dr discussed. In this video it is 'pulled' through not pushed.

I'm like you and needed to know exactly what was going to happen. The videos I watched of my procedure helped me better prepare and eased my worries. Watch this one if you are prepared for the ACTUAL procedure not an animation. It isn't pretty--be prepared. SILS Vaginal Hyster

Yes a camera is inserted, the 'cutting' is mostly cauterizing and the cervix is removed with the uterus through the vagina which is then stitched closed.

I hope this helps you understand what will happen. Getting all your questions answered isn't always easy, that's why I liked the videos even though they can be difficult to watch. My Dr wasn't the best at answering questions either. He may have done thousands of hysters but i was my first.

If it doesn't make you squeamish, there are several good videos on you tube.

I had a hard time understanding as well, it really helped me to watch the procedure.

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Originally Posted by inva If it doesn't make you squeamish, there are several good videos on you tube. I had a hard time understanding as well, it really helped me to watch the procedure.

I tried watching a couple, I wasn't squeamish, but just didn't know what I was looking at. I wish someone would have narrated them!

	Quote:
Originally Posted by toonces Hi Doodle! I wish I had answers for you. I'm just here to cheer you on and offer my opinion that I don't think you're a control freak or anything like that for wanting to know exactly what is going to be happening during this procedure. Doctors are human and some of them just don't have the people skills/bedside manner we'd like them to have! She may have been more helpful in person, so she could illustrate more for you -- who knows? A second opinion could be an option if moving the date out is also an option, I'm thinking. This is a major event in your life -- you need to feel comfortable and confident in the steps you're taking to get there. I hope you get your answers and keep us posted on how it's all going for you!

Hi Toonces! Loved that sketch on SNL!

Thanks for your response! She actually was my second opinion! My gynie is a very nice lady who I have been seeing for several years. She doesn't have much of a bedside manner, either. Must come with the territory! She actually referred me to this surgeon, and I went with the surgeon because she specializes in gynecological oncology, she pretty much just does these procedures and doesn't have much of a "real" gyn practice, while my regular gyn does the whole gamut--paps, pills, delivers babies, yeast infections, etc.

The surgeon was one of the pioneers of the SILS technique in my area, and teaches the procedure, and has been published. She seemed much more experienced than my regular gynie, but I think part of the problem is that I have no relationship with her, no history, I only saw her twice, both times for about 3 minutes. Ultimately, I think she is the best person to do the surgery, I just wish I knew what she was doing!

	Quote:
Originally Posted by Pattypat Doodleowner55, You got me wondering about the SILS hyster too so I found a video in the HysterSister collection. It is VERY GRAPHIC and not everyone will want to watch it, it is an actual surgery removing the uterus through the vagina like you and your Dr discussed. In this video it is 'pulled' through not pushed. [/color] I'm like you and needed to know exactly what was going to happen. The videos I watched of my procedure helped me better prepare and eased my worries. Watch this one if you are prepared for the ACTUAL procedure not an animation. It isn't pretty--be prepared. Yes a camera is inserted, the 'cutting' is mostly cauterizing and the cervix is removed with the uterus through the vagina which is then stitched closed. I hope this helps you understand what will happen. Getting all your questions answered isn't always easy, that's why I liked the videos even though they can be difficult to watch. My Dr wasn't the best at answering questions either. He may have done thousands of hysters but i was my first.

Thanks, Pattypat!

I loved your comment, the dr may have done thousands, but this was your first! So true!!

I can understand the organs being pulled through, can't figure out how they are pushed. I asked if it was like delivering my own internal parts, but she was not amused. I will watch the video and see if it helps. Thanks for posting that link!

OMG I watched that video, it was definitely graphic! Well, I said I wanted to know exactly what they were doing! Now my belly hurts just thinking about having that port installed in my poor belly button!

Sorry! I tried to warn you. I understand your thinking--it is one big port. Is it better than four, five or even six smaller ones? The single port method does have a larger incision than any of my four small incisions--but then you only have one. It's amazing how many options we now have. This ain't your grandma's hyster.

I personally don't care all that much about a surgeon's bedside manor if I'm looking for a top notch surgeon. Have your regular gyne answer your questions or a nurse in the surgeon's office. If I wanted a SILS, the bedside manor is second behind surgical skills. But that's me. There are other ways to get your questions answered and other people to hold your hand if that's what you need. I've seen lots of complications that may or may not have been caused by less-than-the-best surgeons. I want to feel I found the best. You seem to have found one. Everyone has their own priorities. One of my surgeons was known around the hospital as Dragon Lady! She took good care of me.

I've had two surgeries that used my belly button for a port. It healed very quickly and you can't see any scar.