Laparoscopic or Abdominal for Supracervical?

I'm planning to have a supracervical hysterectomy this fall & am weighing the benefits of both surgeries. Right now, an abdominal hysterectomy with an epidural seems more appealing than laparoscopy because I'm scared of the short- and long-term effects of general anesthesia & the possibility that a laparoscopic proceedure could last as long as four hours. My priority is my health in the long term. Recovery time is not a huge issue assuming I could return to work in about four weeks and am not in a huge amount of pain. Also, I do have the best surgeons.

Is it smart to avoid general anesthesia? Is the incision the major part of healing, or are the internal stitches the issue? Anything else I should know that's not obvious or commonly known?

My problem is a 7-centimeter fibroid in the uterine cavity that causes heavy periods. I had a uterine artery embolization done about a year ago, which didn't work except to shrink the fibroid a small amount.

I would appreciate your advice. I've been enjoying reading all your posts & must admit that thinking about this stuff has been a welcome distraction from the crisis here in NYC.

Maybe I am wrong, but I was not given the option of an epidural for my SAH/BSO. Maybe it is because I am also having my ovaries and tubes removed(??)

I can say that I have had general anesthesia 6 times without any problems. I do hope that this upcoming surgery is my last. I have also had one of my laparoscopies last 4 hours, again, without any problems.

Hope this helps.
Cat

PS I can only imagine what it is like to live in NYC. We may live in CT, but DH works downtown and witnessed the disaster from about 150 yards and got out just before first collapse. I do not know if he will ever be himself again.

God Bless!!

Hi,

As far as the length of time a surgery takes, it depends on what the doctors are looking at once they are inside. An abdominal surgery does not necessarily mean shorter.

The healing process covers both the internal and external healing. There are many stitches inside that do not heal as quickly as those that are visible. It generally takes about 6-8 weeks recovery time, before returning to work. This does not mean you are healed. 6 months post-op is about the time you reach 80%, and up to 1 full year to get to 100%. This of course is barring any possible complications.

Discuss your surgical options with your doctor. Not all doctors perform all of the different types of surgery. Some doctors prefer general anesthetic over epidural, and vice - versa. Your doctor would be able to tell you what he/she has to offer, and should be able to help you make your decision by helping you weigh the positives and negatives of the different procedures.

Your recovery period will definitely be longer than four weeks regardless of which route you chose. On the abdominal versus laparoscopic issue, one of the things that kept coming up when I did pre-hyst research was that laparoscopic requires a different level of surgical skill so be sure you are comfortable with the number of laparoscopic hysterectomies your surgeon has done before you go that route. Also, be aware that even if your surgeon is really good at the lap hyst procedure, sometimes they end up having to open you up anyway if they get in there and can't do the job they need to do with a lap incision. Not the norm, but it can happen.

Do a search on epidurals, there are a lot of ladies that had their surgeries with some kind of block and really did well.

Thanks so much for your advice. You've given me lots to think about. I've decided to go with laparoscopy, but now am debating whether to leave the cervix. I'm very confident in the surgeon I've chosen, but he and the other minimal access doc I saw both said their patients routinely go back to work after 2 weeks, maybe 3. I'm counting on 3, give or take a few days, but from what I'm reading here, maybe I'm in for a surprise.

I haven't scheduled the surgery yet but am trying for this month. (Any problem with scheduling it for PMS week? Is there an optimum time of the month?)

All this info-collecting is soothing my nerves, which are starting to kick in!

	Quote:
Originally posted by Wynona Thanks so much for your advice. You've given me lots to think about. I've decided to go with laparoscopy, but now am debating whether to leave the cervix.

Dear Wynona,

Ask your doc if your fibroids would preclude you keeping the cervix.

Get smart about your symptoms & your options, and make the best choice for YOU.

Sending cyberhugs

Wynona, I can only speak for myself and the fact that I had a LSH. I went back to work after 2 weeks and did just fine. I kept my cervix and as a result didn't have any stitches (internal or external) zip, nadda, zilch. My doctor gave me the all clear to go to work, drive, have sex etc after the 1st week (he was also willing not clear me to return to work for 6weeks). He left it entirely up to me.


From my reading here on the hystersisters there can be a pretty significant difference in recovery times if you decide to have your cervix removed along with your uterus.

I had my 1st annual today exam today (pap) included and my PCP said my cervix looked great - nice and pink.

Gather the info, talk to your docs and go with your own best instinct!

Wynona,

I had an LSH last December 26. I would say I was 80% recovered after about 10 days, and was able to start exercising about 13 days post op. I stopped using the pain meds after only about 5 days and relied on motrin or the like. It really wasn't bad. I was under anaesthesia for about 3-1/2-4 hours. My uterus was fairly large (~20 weeks gestational size) with fibroids and one large fibroid hanging off the back into my pelvis. The video tape is amazing, how they can remove that much tissue without making a large incision is astounding.

My regular GYN wanted me to have a standard abdominal, but for me ,recovery time was more of an issue than surgery time. I only spend about 13 hours at the surgery center, didn't even spend the night.

Good luck to you,

Julie

My Dr suggested and I agreed pre-op to leave my cervix. I had never had an irregular pap and there is no family history of cervical cancer. I really wanted to keep my cervix because I guess I liked the idea of having that part of my anatomy staying the same and there was no need to remove it.

Unfortunately, 10 minutes prior to surgery(I was already in the OR and out of it), my Dr got the results from my pap done on 9/14. It was abnormal!!! The first time ever!!! Anyway, my Dr. made the decision to remove my cervix. We had discussed leaving vs taking the cervix one last time before I went under and we were both very specific about leaving my cervix unless he found a reason not to.

The point of all of this is that, while I agree with my Dr.'s decision, I was really disappointed. I'll get over it, but I never really realized how much I wanted to keep my cervix.

My advice is do what you feel most comfortable doing considering your Dr's advice. I would not have something removed without a compelling reason.

Good luck making the decision that is best for you!!
Cat

Hi! I live on Long Island. I am scheduled for an abdominal supracervical this Wednesday. I wanted to do a LSH, but I couldn't find a doctor who accepts my insurance. Can I ask who you used? Thanks.