dVH/RALH: How is uterus removed?

My understanding when I had my initial visit with my surgeon was that he is going to attempt to remove my uterus only, leaving my ovaries and cervix, using the da Vinci robot. After examining me, I asked if a vaginal hysterectomy would be possible, and he told me that no, it wouldn't, because my vagina was too small since I've never been pregnant or given birth.

At the pre-op visit, the nurse had a form about vaginal uterus removal, and I told her that mine wasn't being removed vaginally. She asked me how they were removing it, and I said that I guess through one of the incisions. She seemed bewildered and said she didn't know that's how they did it.

Am I correct? I understood that the uterus is cut into pieces and then removed through one of the incisions with the da Vinci method. I called and left a message with the NP, so I guess she'll call me Monday and clarify, but now I am doubting myself.

Thanks for any and all information.

Dana B. in Houston, TX
Novassure Endometrial Ablation 2005
Supracervical da Vinci assisted hysterectomy scheduled 7/16/10

I am having the DVH like you. My surgery is Tuesday. I had my pre op appointment today and that is how he told me he was removing my uterus also.

So, I believe you are correct.

Good luck with your surgery!

Go to hysterectomy options at the top of this page, and then click on da Vinci ....it gives you a description.....your nurse may have simply been unaware of how the procedure works....

I was told that in a DVH the uterus is removed through the vagina (at least for mine it would be). I don't see how an organ that large could be removed through incisions that small!

DRB -

It's good that you are asking questions and getting clarifications from your Dr.

What it usually depends on is whether you are keeping your cervix (supracervical hysterectomy) or it is being removed (total hysterectomy).

If you are keeping your cervix you are correct the uterus would be removed via the incisions. It is cut up in strips and removed via the incisions. Frequently you will hear members say they had extra bruising on one incision and that often is the one used to remove the uterus.

For a total, usualy what happens is a device is inserted into the cervix and it is expanded to identify the cut line for the surgeon, after the rest of the uterus had been detached. Once the cervix is detached from the vagina everything is removed vaginally. The vagina is stitched at the top creating a vaginal cuff.

I personally haven't heard of them doing a total and removing everything via the incisions but anything is possible. So getting that clarified from your Dr. is the best thing.

FYI, I never had children either but was able to have everything removed vaginally. In your case, as you said, your anatomy may not support that but it isn't a 100% thing.

as you prepare for your surgery.

G.

Just adding another voice of agreement!

I had a daVinci supracervical hyst and my uterus was removed through one of the incisions.

Unless you have cancer it is cut and bagged and removed via one of the incisions. If you have cancer, they do not want to cut it up internally, but to remove it intact, and ovaries and cervix go, too, as Tauruslady described. Mine came out vaginally last week. It's really an amazing procedure either way.
Suzanne

It also depends on how big your fibroids are. I had 3..a 2.5 cm, a 11.5 cm and a surprise whopper at 20 cm! No way could they have been removed by incision site out the vagina they came along with my cervix! Good luck

Here are the dimensions listed on my report:

Fibroids measuring 35x32x35 mm & 15x15x15 mm
Uterus measures 84x54x54 mm
Endometrium measures 14 mm in diameter

I have no idea how big this is in actual inches or in comparison to something -- the NP told me that a normal uterus is approximately the size of a medium sized lemon, and that my uterus is approximately the size of a baseball, or slightly larger than that.

Thanks,

Dana B.

I had total hyster via daVinci and everything was removed vaginally.