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How often do they have to change the surgery type? How often do they have to change the surgery type?

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  #1  
Unread 09-17-2011, 01:06 AM
How often do they have to change the surgery type?

I'm scheduled for the LSH next week. I like the idea of smaller scars and shorter recovery time, but I am concerned because of the size of the fibroid, and because of it, my uterus. The doctor feels confident that it's not going to be an issue, but really? How often do they need to change tack in the middle of surgery when they really SEE what they're up against? His words in the office were "massive," "bulky," "big," and "heavy."

Ugh! I just want to be on the other side of this so I can stop worrying all the time about what ifs!

I'm glad to have found this forum. I am new and really trying to figure things out.
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  #2  
Unread 09-17-2011, 01:57 AM
Re: How often do they have to change the surgery type?

It does happen: don't know if there's a percentage that will help you. My doctor prepared me for both scenarios, and I woke up with basically a cross between laproscopic and open abdominal: my incision is about three solid inches, which was somehow enough to get out a fibroid the size of a full term infant.

I read that the largest lap surgery ever done in India involved a 19 pound (!!!!!) tumor: be prepared, I'd say, for either, but trust your doctor's sense that lap is very much on the table for you now.
  #3  
Unread 09-17-2011, 08:41 AM
Re: How often do they have to change the surgery type?

How is it possible that some women with large fibroids are able to have their hysterectomies in any other than abdominal?

Are you given choices?

Like, my doctor told me abdominal is the only options. Which I'm fine with because it gives me peace of mind knowing that it won't be changed during the surgery.
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  #4  
Unread 09-17-2011, 09:29 AM
Re: How often do they have to change the surgery type?

Mine was large also and lodged between my pelvic bones. Doctor did it all laproscopically. It took 3.5 hrs instead of the 2.5 he originally thought, but he took his time and did it.

When we discussed options before surgery he had said that the only reason he might not be able to do it laproscopically was if he could not see the blood vessels once he got in. That is not something you can tell from any exams. He also said he prefers laproscopically because it is more fun for him.

I am just about 6 weeks out from my LSH and feel better than before surgery, and am back to all pre surgery activities.

Good luck!
  #5  
Unread 09-17-2011, 11:45 AM
Re: How often do they have to change the surgery type?

Thank you all for your replies!

I'm glad that LSH is possible for large fibroids now. The doctor did say that I had a choice, but that he felt this way would work.

Honestly, if I had a real choice, I would prefer to do the abdominal. I know that sounds backwards, but I've never been under general anesthesia for that long before. That worries me. I would prefer the doctor make whatever incision he needed to be able to SEE everything clearly.

The reason I opted for the LSH is my mother. I'm HER caretaker! I'm the only licensed driver at my home too. Getting me back on my feet and functional as fast as possible is a priority.

I know that's a priority for everyone who goes through hysterectomy. I just hope that everything goes smoothly, and the doctor can see what he needs to see.

I'm a single mom as well as caretaker for my own mother. It just seems like as soon as a woman gets to the point where she's starting to feel comfortable in her own skin, takes on responsibilities for others, her own body betrays her.

The other thing that amazes me: I didn't KNOW until 3 months ago I had this thing! How is that possible? I'm not obese. I've always known when my body was "off," but this completely snuck up on me!
  #6  
Unread 09-17-2011, 11:50 AM
Re: How often do they have to change the surgery type?

That explanation about the blood vessels makes sense: for my procedure, the surgeon's reasons for a possible switch also had to do with whether she could get a decent view and ample access. Ultimately, lap may give you a couple weeks less healing time, but it's not worth pushing for that if your surgeon feels like that would be a sub-optimal way of getting stuff out.

What helped me tremendously was getting the information from my surgeon that she had successfully done both kinds of procedures, and her taking the time to describe why she'd choose which when she began mine. Once I trusted that her choices were guided by my actual case, not what she did and didn't know how to do in general, I felt very good about whatever she decided.

I'm right there with you on the "how on earth did I not notice?" thing: there is a medical term, quality of life creep, for it. Stuff changes so slowly, so insidiously, that we make our adjustments without consciously registering that there's even something there to adjust to. I wanted to slap myself six ways from Sunday when I got my ultrasound results (tumorous mass of 24 centimeters????), but it's just what happens at times: if you woke up one day and suddenly had what you've been getting all along, you'd rightly freak out. But it's harder to notice something as incremental as a millimeter change in your uterus at a time.

Best wishes to you: things can get so much better from here!
  #7  
Unread 09-17-2011, 11:50 AM
Re: How often do they have to change the surgery type?

  Quote:
Originally Posted by barren View Post
How is it possible that some women with large fibroids are able to have their hysterectomies in any other than abdominal?

Are you given choices?

Like, my doctor told me abdominal is the only options. Which I'm fine with because it gives me peace of mind knowing that it won't be changed during the surgery.
I was given options for which kind of surgery. I based my choice on recovery time because of my home commitments.

I think that training, facilities, the doctor's own confidence in his/her skills, and your test results would have had an impact on the best surgical option for you.

I was amazed it was an option at all for me.

Good fortune!
  #8  
Unread 09-17-2011, 12:02 PM
Re: How often do they have to change the surgery type?

I had a large (10 cm) fibroid and my uterus was the size of a 4 month pregnancy. My dr. wanted to do the davinci laproscopic surgery. I was happy with that because I knew it would be an easier recovery. She told me that she "SHOULD" be able to do the surgery that way. So...I was kind of preparing myself for an abdominal incision when I woke up. When my dr. did my surgery, she found another large fibroid behind the large one. She said that two or three times during the surgery she thought she was going to have to change routes and go abdominally, but she just kept at it, took her time, etc., etc. My surgery was supposed to be about 3 hrs., and it ended up being 5 1/2. I don't know if it's better to have a longer surgery, with no abdominal incision...or a shorter surgery and have the abdominal incision. I know I was grateful that I didn't have the abdominal incision to deal with! I'm a single mother, and I think my dr's main goal was for me to have the most easiest and shortest recovery time possible.
  #9  
Unread 09-17-2011, 12:12 PM
Re: How often do they have to change the surgery type?

I had no idea what kind of surgery I was going to have. My doc was going for an LAVH but I had to sign off on basically any other kind that made more sense at the time including the possibility of taking my ovaries if they were diseased. So it was a mystery! I ended up having an LAVH but with 4 incisions instead of 3. He said I gave him a real work-out (two 9 cm fibroids along with many other smaller ones). I was able to keep ovaries. 4 days pot-op and feel pretty good. There were about 2 pretty tough days where I felt like I had a bad case of the flu. I really think the worst is over as soon as the surgery is behind you! Then it's all just recovery time. Best of luck to you! Pamper yourself before and after! It's a great time to focus on you. Both inside and out
  #10  
Unread 09-17-2011, 01:37 PM
Re: How often do they have to change the surgery type?

Thanks mgcam! I have a pre-surgery appointment with the doctor scheduled the day before surgery. At that appointment I had planned on discussing that I was okay with whatever he felt was appropriate at the time of surgery. I know how unpredictable things can get. Transcribing surgical procedures for my school training makes that pretty obvious.

I'm glad that you are feeling so much better after your surgery!

I've been told by several people to let others take care of me. That's going to be hard for me, but not impossible. :wink: This whole week is going to be ongoing pain issues for me, so taking it easy as much as possible is a given.

Having 3 herniated discs in my low back makes menstruation double hard. Everything is connected with muscles, tissues, and ligaments in that area. I just started pre-surgery TOM. I will be interested to find out after everything is healed up whether some of my back pain eases off without cramps and menstruation being a factor.

Thanks again!
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