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10cm ovarian cyst- di vinci hysterectomy?  or not? 10cm ovarian cyst- di vinci hysterectomy? or not?

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Unread 08-02-2008, 04:01 PM
10cm ovarian cyst- di vinci hysterectomy? or not?

I'm a newbie here. I went to ER with a kidney stone a couple weeks ago and when they did a Cat Scan they found a 9.6x6.4x8.2cm ovarian cyst. After lithotripsy for the k stone, I followed up with my regular doctor who sent me for a pelvic ultrasound which confirmed a tumor. She referred me to a gyn/oncologist surgeon and I met with him 2 days ago.

After telling him I want to be out of the hospital as soon as possible...
My options are as follows
- laporatomy (open surgery)
- Di Vinci Hysterectomy (he is willing to attempt it, but says it my be too technically difficult and he would have to convert to open surgery anyway)

I am 51yr old, and have had 2 c-sections (over 30 years ago) so he would use the same scar (strait down from my belly button). I also had gastric bypass 2 years ago and lost 130#.

Anyway, I wondering if I should just do the open surgery which would hopfully be benign and only loose my left ovary and tube, or attempt the di vinci hysterectomy just so I could get home quicker (I have 3 great danes and they need me at home)?

Any thoughts are welcome...I'm going in circles here!
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Unread 08-02-2008, 05:06 PM
10cm ovarian cyst- di vinci hysterectomy? or not?

I wonder if you could get yet another opinion with a surgeon more experienced in either DaVinci or Laparoscopic Supracervical Hysterectomy? There are many who are very well-trained and have a very low conversion rate (% of surgeries that change over to open abdominal hysterectomy). I was very fortunate to have a surgeon with a conversion rate of less than 1% and had been performing LSH for almost 20 years. I was out of the outpatient center in 7 hours and back home (four hours away) two days later. I also returned to work at 10 days. (and I have 3 canine babies at home, so I know what you mean). I just believe you may have other options.
I wish you lots of luck.
Unread 08-02-2008, 05:36 PM
10cm ovarian cyst- di vinci hysterectomy? or not?

Thanks for the reply...
I don't need a hysterectomy...only a removal of the left ovary and tube. BUT IF I let him attempt the Di Vinci, then it would have to be a complete hysterectomy because it all comes out the vagina. The only reason for the di vinci is for my request to save me time in the hospital.

I'm not a very good canidate since I've never had a vaginal birth, and because I very small inside...I have tiny hips. Plus the tumor is almost 10cm. But my surgeon said he was willing to attempt it, but would not place me in risk. If it became technically impossible he would convert to open immediately.

My surgeon runs the gyn oncology dept and has a great reputation, so I do have faith in his abilities. I just wonder if I should get a hysterectomy if I don't need one, just to save me a couple days in the hospital?

My gut says no...but I know nothing about hysterectomies...that's why I'm so glad I found this site! Can I really expect to loose my hair, be incontinent, brittle bones, vagina odor, and bowel problems after a hysterectomy? That's all the info I've had a chance to read yet (not on this site)...if so, then maybe I should just have the open surgery and not do the un-necessary hysterectomy.

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Unread 08-03-2008, 06:14 AM
10cm ovarian cyst- di vinci hysterectomy? or not?

I see. Just so you know, I have not lost hair, become incontinent, developed brittle bones, have va - jay jay odor or bowel problems My goodness, you've been reading some wicked stories I feel better than I've ever felt. I don't even know anything's missing, except I have no pain and no monthly ups and downs (and NO PERIODS!!!!). It's the best thing I've ever done for myself. I'm glad you've got an excellent doctor. Hard to say in what direction you should go. Good luck. I wish you the best. Please keep us informed on your decision.
Unread 08-03-2008, 06:52 AM
10cm ovarian cyst- di vinci hysterectomy? or not?

Oh...Ok...thanks! That's what I was looking for Someone to tell me the horror stories are NOT true!
Thanks so much! I will continue to read, but definately look around this site first
Unread 08-03-2008, 12:40 PM
10cm ovarian cyst- di vinci hysterectomy? or not?

Hi Weimerdane,

This might seem out of left field ...but you might think about getting a 2nd opinion, even if you feel good with what your Dr. said. I got two opinions myself and it is still one of the best things I ever did. A 2nd opinion gave me more information and a comparsion to my 1st opinion.

I agree with Klgm and if you do choose a hyst...you might check on the LSH and from what I understand from being on Hyster Sisters, the DaVinci can also be done similar to a LSH...with no vaginal work and the cervix is retained. So you might check with your Dr. about that.

I had two fibroids measuring 9.1 cm total at the time of my hyst. With my LSH, I had two small hip inicisions and a belly button incision and I had no vaginal work...as I am sure was the same with Klgm's LSH.

I can suggest going to the *Hysterectomy Checkpoints* link at the top of the page. Go to the *Pre-op* link and scroll down on that. It goes over the different types of hysts.

I agree with Klgm and sadly, there can be some stories. I was 46 when I had my hyst four years ago and my LSH is still one of the best things I ever did for my long term health. I got my ~quality of life~ back with my hyst.

Best wishes~

Unread 08-03-2008, 11:38 PM
10cm ovarian cyst- di vinci hysterectomy? or not?

I am going to assume that cancer is suspected since you were referred to a gyn/onc. Does he feel it might be cancer?

Usually for cysts that are suspected to be cancer, they like to do the open surgery so they have the best chance to remove the cyst in tact. The reason for this is that if there are cancer cells, they are reducing the chance of cells leaking into your abdominal area and allowing the cancer to spread.

Unread 11-28-2009, 05:05 PM
Re: 10cm ovarian cyst- di vinci hysterectomy? or not?

Hi Weimerdane,

I just read your post from a good while back. I have a similar situation. I have been told that I have a 8cm cyst on left ovary. My gyn suggested open ab surgery to remove just the cyst. She said she didn't think it is cancer. I wanted a second opinion so I asked my PCP to refer to to someone. He referred me to a leading gyn oncologist in our area. This doctor wants to do daVinci and said he want to do full hysterectomy... both ovaries, tubes, uterus, and cervix all pulled through vagina. He said at my age (52) and post menopausal for about 3 years it was for cancer prevention. He said since he had to be in there anyway he wanted to take it all. He said he would hate to see me back in his office in 8 - 10 years to treat me for cancer he could have prevented. Cancer does run in my family (colon and breast cancer). I am confused. I could let my reg gyn do the surgery with abdominal or let the oncologist do daVinci with full hysterectomy. He also said if he took it all he could better control the blood loss and it would be a safer procedure.

What did you ultimately decide? How did things go and do you have any regrets. How was your recovery. I live alone and have no family nearby. My daughter is away at law school. I am scheduled for surgery 1/6/2010. Do you have any hormonal issues?

I do hope you get this post as I see it has been a while since your original post.

Thanks so much.

BTW - I have four-legged friends to take care of myself (standard poodles and two cats)

Unread 11-28-2009, 06:14 PM
Re: 10cm ovarian cyst- di vinci hysterectomy? or not?

Weimerdane -

The daVinci surgical system can be used for a salphingo oopherectomy (removal of a tube and ovary). In this case it wouldn't / shouldn't result in anything being removed vaginally. There are several members here who have had the daVinci surgical system used in partial hysterectomies (removal of the uterus where the cervix remains).

There are instances where the surgeon has to convert from a laproscopic surgery to an abdominal surgery and that usually has to do with either scar tissue and adhesions (possibly from other surgeries) or from complications during the surgery.

I would seek a second opinion, I am not sure why he believes it to be too technically difficult. Have you asked him about how many surgeries he has done using the daVinci system?

My original Dr. told me that they couldn't do cancer surgery using the daVinci system and that isn't true. As for removing ovaries and all as prevention for future ovarian cancers the statistics indicate this is not common so many are opting to keep their ovaries (unless cancer runs in the family or there is an endometrial cancer diagnosis) since the ovaries continue to produce hormones even post menopause.

My personal opinion, I would start laproscopically and if they have to convert they convert.

Oh and with large dogs be careful you are still having surgery so be careful.

Unread 11-28-2009, 07:06 PM
Re: 10cm ovarian cyst- di vinci hysterectomy? or not?

Hi Newbie!
I'm 14 months out now and my experience went well. I elected to let the Oncologist do an OPEN ab surgery...mainly because I've had several ab surgeries in the past (2 c-sections, and weight loss surgery) and wanted him to be able to open me up and really clean me out and be able to see everything else in there was ok.. I had a complete hyster including cervix...for the same reason that they gave you, and am so glad I did! I also elected NOT to do hormone replacements and did not take ANY meds to control the hot flashes etc.

This turned out to be a great decision for me. #1 they found so many adhesions in my gut once they got in there, that everything was glued together. Also, my appendix was inflam. and was a time bomb so they took that out too. My bladder was doubled over so he was able to fix that too! (I haven't be able to pee this much is a long time So my surgeon was glad that he opened me up...he said he would probably have started the De Vinci and would have converted to an open anyway... He was glad he had an open gut that he could go in and see everything and really clean it out. I was in the hospital for 2 days, and the recovery was not bad at all. I did have a friend come and stay with me a week, but I was up and moving around enough that I could have done it myself if I absolutely had to. Just make sure you plan and have enough supplies on hand so you don't have to drive for a week after surgery. I also bought a bed bar to help me get out of bed for $40 and love it so much I still use it .

Here is the item # that I bought on ebay:
item #130348065717 currently on Ebay, since I can't post a link in this response.

I was back at work in 5 weeks (part time) and full time @ 6 weeks. Don't rush your recovery...if you can, plan to take to full 6 weeks off work...you will feel really good 3 or 4 weeks, but the stamina won't be back yet, and you need to baby yourself so you can heal properly, and not have any internal bleeding.

I decided not to take any meds for HRT, including the antidepressants my PCP wanted to put me on...I didn't like the possible side effects when I researched them. This was a good decision for me also. I did have hot flashes, but they only lasted less than 60 seconds each and pasted quickly, and by 6 to 8 months out they were far and few between. I also had the occasional flair up in emotions…but realized what was going on and was able to take a deep breath and it pasted quickly too. I'm 14 months out now and don't have any menopausal symptoms at all. We are all different, but that's my experience. Also, Just so you know, I have not lost hair, become incontinent, have va - jay jay odor or bowel problems. I’m taking calcium supplements and will go for a bone scan next week to check on brittle bones.

The dogs did fine…I had to be careful when I got home from the hospital that they didn’t jump on me because they were so happy to see me, and had to keep pillows across my stomach in bed so they didn’t accidently step on it when they got in bed with me…but over all we just laid around and slept a lot…LOL. I love standard poodles! They are great dogs and I hope to adopt one … one of these days 

Have a couple weeks worth of food (easy to heat up, and easy to digest), and other supplies to last a couple weeks (toilet paper, movies, books) and if you have someone who can at least help out a couple days after you get home (work friend or neighbor) who can stop in or call a couple times a day if they can’t spend the night…then hopefully your recovery will go as well as mine did.
The best advice I got was “Don’t turn down any offers of help”. When the guys at work, and my church friends asked what they could do, I told them – bring me some dinner, drive me if I need it, …and they brought casseroles and wonderful things and I was so humbled by the generosity that came, just with me saying “yes, I could use your help”. So tell people what you are about to go thru…it’s scary, and you will need some support if it is offered. They can also drive you places if you need.

So you need to decide between the Di Vinci and open surgery… open tuned out to be the right decision for me due to my history and the recovery was good and not bad at all. The main difference is 2 weeks back at work with Di Vinci or 5 weeks back at work with open, and I had the option of paid sick leave to cover my time off work (my work team actually donated some of their leave time to me to help me out). Either way, I think I would let the Oncologist do the surgery (either open or Di Vinci) simply because he would be in there if something unexpected came up, and they have specialized skills in this area.

Let me know if you have any more questions. This site was a God Send to me…just research and plan and hopefully everything will work out as well for you and it did for me. Mine turned out not to be cancer (Praise God!), and was told most cyst are not cancer.


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