Incision, Vertical vs. Horizontal

Hi everybody,
I have endometrial cancer and will have hyst. soon. The surgeon says he can do a horizontal cut but that he can get a better look at everything with a vertical incision. Says he can suture it but for speed he may staple it. My husband says he'd prefer if I don't have a big scar. Would you please share your thoughts, advice, experiences on this? Thank you!

Judy

s Judy

I had a vertical incision for my ovarian cancer surgery. It runs from the right side of my umbilicus to the top of my pelvic bone. I also had staples. My scar is very faint and smooth a year later. The part of my incision near my umbilicus was the slowest part to heal. And now a year later I have a small incisional hernia in that same area. My gyn onc surgeon said with that area healing a bit more slowly, and then starting chemo at three weeks post op, it kinda triggered this problem. The staples were practically painless to remove. I'm sure they were no more uncomfortable that sutures.
If I were you, I would let my doc make the decision. I hope your doc is a gyn onc surgeon. He/she will know best how to facilitate what they are looking to check out.
As far as your husband's comment........... I won't go there........

karenann

The surgeon (second Karenann it should be gyn/onc) should make the decision about which incision to use to best do the surgery and view the area. I have the vertical incision--from just below breastbone to pubic bone. I was stapled shut. I have never had a bit of trouble with the incision at all (not even itching) and honestly, after a year it looks really good--I mean, not stretched out nor really visible. Now getting the staples out...well, if I tell you that for the surgery prior to that, in 1980, I hid in a bathroom in a neighboring unit for a morning after the Dr. mentioned he MIGHT take stitches out that day...I'm a major chicken and admit I wasn't a model patient--but honestly--it is NOT that bad and they don't leave marks. Let your surgeon decide.

I had a horizontal (actually used old c-section line), and because of all the yanking and pulling and retracting, I had a huge hematoma (swollen looking bruise) for a few weeks.

I was also warned that if he (the gyn onc) thought it was necessary I might end up with a "T", meaning if he might have to do a vertical one after the horizontal The horizontal ended up being pretty big though - from one hip bone to the other.

Honestly, I felt the scar looked pretty nasty for a few months, but like the others it is really pretty faint now (and it's not a year yet). I'd let the doc decide this one.

Hi Karenann, I agree with you about my husband's comment...
Okay, so the incision went from the umbilicous, (is that bellybutton?), to the the pelvic bone. And your scar is faint. this is good news. I have a surgical scar on my leg that looks like a shark bit me. The first year it had an area that sounds like the one you are describing, but it has faded away very nicely.

Does anyone know if there is a medical dictionary for cancer terms? I need to look up "apoptosis." Thanks!

Judy

Hi Judy,
I am part of the "verticle" club as well. I didn't have a choice at all, and mine goes from just above my belly button to the pelvic bone. Like Karen and Ellen, I had staples, and healed beautifully. Even my onclogist at the last checkup said how good it looked and how well it was fading.
The only thing I will say is that they could have cut me anyway they wanted to to see everything they needed to see. Its cancer....and its sneaky.....and I wanted them to be very sure they got it all. I even told my doctor the morning of surgery....."take my bowel, bladder, liver....do what you have to do...just get this the hell outta me"....and I meant every word of it.

I was not in a relationship when I took ill, but my very own opinion is.......if this were reversed and it was your husband having surgery for cancer....wonder how he would feel about you being concerned with the position or size of the scar.
I would rather live 50 years with a big scar than 5 with a neat little scar and the possiblity they didn't see all they needed to see.
But really Judy...with the staples there is very little scar. I can't say I would be comfortable enough to wear a bikini....but its not something that I look at and think is awful or ugly looking. I consider it my "battle scar"
Hugs
Maria

Another sister posting from the wars.

I agree you should let the DR (and that *would* be a gyn/oncologist, right) do whichever incision he wants. They need room to manuveur in there. I can't begin to tell you the peace of mind I feel when reading my surgery report that the gyn/oncologist checked my kidneys, liver, gallbladder, bowels and a few more odds and ends with his highly-educated and experienced (that would be cancer experienced) eyes and hands. It's feels like I got the "Good Housekeeping Seal of Approval."

I always say women are stronger than cancer *punch* but we can use a lot of backup. Let your doctor give you some extra backup by checking everything he can. It's like getting a second operation for free!!
s,
Laura

apoptosis is cell death--some refer to it as "cell suicide" so in general in reference to cancer, that's what you want to have happen to the cancer cells--have them throw their little hands up and fall over.

I've got to put my vote on letting the doctor use the incision that has the most success for your situation. I do understand the worry, but after all worrying about the aesthetics of your scar is a luxury. There are some good things to make scars be less red and flat. I used Mederma to good effect.

I'm reluctant to say this because what do I know, but it keeps popping into my head, so here goes--you already tried to minimize and control treatment by taking hormones instead of taking the conservative route. It didn't work. I think I'd take this as a sign that the conservative route is a bad idea for you. I'd go with whatever the gyne/onc recommends.

Judy
I have about a 5 inch incision from about an inch below my belly button to about an inch above the pubic bone. My onc/gyn said this was necessary to look around at all the organs, even though the ct scan was clean. It was nice to hear him say everything looked very healthy and his visual agreed with the ct scan. '
I can still wear my tankini bathing suit and the scar doesn't even show. I am 8 weeks post op and it is already fading. After my 6 weeks post op I started putting vit e (from the capsule) and Mederma on the incision. The points where the staples went in are completly gone. I think staples make for a much nicer incision. I would go with whatever the onc/gyn feels is prudent.....no regrets that something wasn't checked.....I wanted that visual and the reassurance from his trained eye that everything was fine.
Think of your incision as your badge of courage and something that potentially could of saved your life.
After my 6 weeks post op and dh and I got the go ahead (if you know what I mean) I didn't want dh to look at the scar and I kept trying to cover it..(I didn't think it was the most romantic thing to look at)...He looked me square in the face and said "I love you and I love this scar, it saved your life and I don't want you to ever act embarrased ever again. He kissed my scar and I havent given my "badge of courage" much thought since.
Has your onc/gyn had you do a colonscopy, ct scan, chest xrays?
One additional thought about the incision.....Take it very easy post op when the incision is healing, don't allow the staples to pull, also....when the staples are removed about a week later and the surgi tape is applied....keep it on and after showering lighly dry the surgi tape with a blow dryer. I think pulled stitches cause a whole lot more scarring.

Hi Everyone,
thank you for the wonderful advice. Great tips. It makes such a difference!

Take care.

Judy