Traditional vs Minimally Invasive Hysterectomy

I know that I need to have surgery and have interviewed a few surgeons. Now left with the decision of whether to go with an open hysterectomy or minimally invasive surgery. I'm concerned about the morcellation process in minimally invasive surgery in terms of the potential risk of cancer spread, even though they've addressed this complication by using a bag in the procedure. It also still seems new and all the possible complications may not be worked through yet. My situation is complicated by my small frame and very very large fibroids inside and on my uterus, resting on both my bladder and bowel. It's a small space with a lot going on.
It seems like it would be easier for them to see what's what if they just open me up and assess the scenario fully but I don't know if that's just my naïveté. As far as the open abdominal surgery, I'm concerned about the lengthy recovery time primarily.
I'd love and greatly appreciate any of your thoughts and experiences with either. Thanks so much in advance. This is something I've put off for long enough and it's way past time to get my oversized, fibroid filled uterus out of my abdomen.

Hi Focused, if you have large fibroids they might have to do it open. Have you picked a DR. I know you were looking for recommendations on the boston area a few months ago?

I had an abdominal hysterectomy with a vertical incision. My pain was the worst right after surgery and the first day in the hospital. I was in the hospital for three days (Wednesday thru Friday) and on the last day had transitioned to just ibuprofen for pain. My doc sent a prescription for pain pills, but I only used ibuprofen. Honestly for me, the experience wasn't as bad as I anticipated. Good luck with whatever you decide.

I had an abdominal surgery, horizontal cut, about 6 inches. It was my first time being cut so I was nervous, and expected much more pain than I had. The hospital was excellent on pain management so that's probably a reason why. I felt comfortable with the abdominal because that cut any chances of spreading tissue/cancer concerns (though I'm not a high-risk patient). Yes, the recovery was longer but by 3 weeks post-op, I felt great. That first week was definitely the hardest, but I was off narcotics at day 5 post-op and went back to walking after one week. I was always more worried about recovery than the actual surgery, but reasoned that recovery was necessary to be healthier. That small amount of downtime is insignificant compared to how much more time I have to do things now that I'm not living around my periods.

I also had multiple and large fibroids (5lb uterus), and I'm also small framed, which wasn't the issue. My uterus was very elevated, and two different surgeons said I would need the abdominal procedure with vertical incision because of that. I had a 4.5 inch incision, ending below my belly button.
There was initially a lot of pain, I'm not going to lie. But I was on pain meds for a relatively short amount of time, 6 days total after release from the hospital. Was in the hospital for two nights.
I'm curious if morcellation of a large uterus would take more time than abdominal surgery. I have no idea, but for me, the less amount of time I'm under anesthesia, the better. Recovery time is secondary to that. I didn't seem to have a choice about the procedure, but it worked out well for me.

I am 20 days out from an open abdominal supracervical procedure.

I had very large fibroids (5 lb uterus). I decided morcellation was not acceptable, thus leaving an open procedure. I had a long vertical incision - the surgeon even had to make a slight cut on the bottom horizontally to fit my uterus out.

Lengthy recovery time was a serious concern for me. I have a one-person law firm and simply cannot be away from my office. It turned out not to be a problem at all. I wish I could go back and tell myself how easy it would be.

I was working from home by the end of the first week and could easily take care of may things around the house. I felt like myself by week two and was working part time and could easily take care of things around the house. By the very end of week two, I was back to work full-time (not physical work).

I basically don't even notice that I recently had a surgery here at day +20. I am still slightly more tired in the evenings, but that is the only noticeable difference from pre-surgery.

Two choices that I made I think were good: 1) seriously research the supracervical procedure if it's an option for you. There are many reasons, but one is that there is less internal healing - thus easier recovery; 2) I had an epidural prior to surgery for pain control that was left in for 1 1/2 days. (general anesthesia for surgery - this was really for after surgery). This basically eliminated all pain, and made taking many other pain meds unnecessary, helping recovery. Also, I worked very hard for 2-3 months prior to surgery to be as healthy as possible, hoping that would speed recovery. Finally, people talk about so many intestinal issues causing havoc with their recovery. I did a lot of research and reading and settled on a totally fruit diet for a few days before, juice only the day before, and fruit and fruit juice only for a couple days after. Absolutely no intestinal issues. Surgery/anesthesia is like going on/off a fast, where things slow down/stop for awhile. By treating it like a fast, I avoided all those troubles.

Best of luck!

Due to size of tumor (20 cm) I had an abdominal. This was my first surgery, first time in hospital. I stayed in hospital 2 nights. I knew I would be in pain but it wasn't as bad as I had imagined it would be. Once you get up the first time it gets easier. Car ride home from hospital was hard due to the bumps in our roads
I feel much better today but still am tired.

Good luck with your surgery whichever you end up doing.

I am also a woman with a small frame, 97 lbs. I at first thought I would prefer minimally invasive laproscopic surgery, but upon further examination, my doc said my cervix was too small for the uterus and fibroids to pass through (I have never had children), and that I would have to have an abdominal hysterectomy. I agree with you, and it was also stated in a book I read about hysterectomy, that it is easier for the doc to see with an abdominal incision, so I was settled with the decision. I am now 7 weeks post surgery and feeling good and doc has cleared me to do everything as before surgery. After I left the hospital, I only took ibuprofen for discomfort. I was very careful not to overdo and followed doctor's orders. I agree with HappyDee that the first week was the hardest. In reality, it is no picnic, it is major abdominal surgery. I had to be patient, allow time for my body to heal, make sure I rested, and accepted all the help I could get.

Deciding to have a hysterectomy was the hardest decision I have had to make. I did not want to do it for a long time although two gynocologists, my oncologist, and husband thought I should. Now that I am 7 weeks post, I am happy that I am well and relieved it is all over and I can move on.

I am scheduled for a TLH on 1/16. No morcellation, even with a bag will I consent to.

Should they not be able to deliver my uterus in one piece vaginally, then I want the open.

So they can do a minimally invasive surgery without morcellation on a case by case basis.

I had TAH due to the size of fibroids and uterus. I had an unbelievably easy recovery. Never had pain, never took narcotics. Walking miles the first week, back to work at 3 weeks, but really could have gone at 2. I was allowed to drive at 1 week, and I did all normal activities except the few that my dr restricted.