Hi, I had the same concerns. So, I made sure to get a second opinion other than what my gynecologist offered because every doctor is different and most doctors only offer (rightfully so!) the surgical techniques they are most experienced and best at.
Now, each situation is unique so there is no "right" answer fits all.
For me, my uterine tumors had grown very fast and I also had some other "iffy" symptoms that indicated a possibly "slightly larger" (but still very small!) chance of cancer being found.
The only certain way to know if there are any cancerous cells present is through the final pathology findings - after removal and testing - so with some patients there is a small risk involved of potentially spreading those cells if things are cut up rather than removed intact.
So anyway, to help with my decision and peace of mind, I sought out a second option with a wonderful surgeon that has a great reputation.
It ended up that each doctor gave me two options, depending on whether I wanted to keep my cervix or not.
My gyno's preferred option was a SUPRACERVICAL Laparoscopic procedure in which she would leave the cervix (by basically cutting the uterus off at the bottom) then in order to fit the uterus through the laparoscopic holes, she would be bagging the uterus inside a sack and drawing it up to the belly button opening and then cutting it up manually inside the sack - with the idea of containing any potential spread if any cancerous cells were found.
If for some reason this approach was not achievable during the operation then, I had to sign a consent form ordering her to either resort to power morcellation, accepting the slight risk of potential cancer, or to instead convert my operation to an abdominal incision and remove the uterus intact.
The other surgeon's preferred option (and highest recommendation) was DaVinci TOTAL hysterectomy - he prefers not cutting the uterus at all, keeping it completely intact, and using the DaVinci approach to remove it intact through the vagina (which obviously means not keeping the cervix since it is in fact not separate but is the bottom part of the uterus itself).
He felt this was the safest route to go with the best possible outcome for solving my health problems and the least chance of infection, and the quickest healing, and least chance of spreading any potential cancerous cells, if found (which he emphasized that the chances were still very small and not to worry). He did feel that the sack approach was not sufficient because it would be easy for a puncture to occur in the sack during cutting up, thus allowing spread of cells.
If I really wanted to keep my cervix, he was willing to honor that and he then would do Davinci but with an additional incision down low in the abdominal wall which would be widened only enough as needed to ease the uterus out intact while leaving the cervix.
So, it was a big decision and so I did a lot of thinking, research, reading this wonderful site and all the great information here, talking to friends and family who have had hysterectomy, discussions with my husband and PRAYING.
I decided in my particular case that the Davinci Total procedure was best for me. I have had a great experience so far and am very happy with my choice so far. I am only 2.5 weeks into healing so I will update as I go!
Hope this is helpful!!