Published: April 10, 2008 11:57 pm         

Laparoscopic hysterectomy online in Enid

Uterine problems often are not something women like to talk about.

Every day can bring constant pain, bleeding and fatigue, leading about 600,000 women a year in the United States to have a hysterectomy. A hysterectomy usually is the solution to the problem, but the benefits are balanced by along recovery period, during which productivity and work generally are discouraged.

Doctors in Enid now are addressing those concerns with a new procedure, laparoscopic hysterectomy, or TLH.

TLH stands for total laparoscopic hysterectomy, a procedure in which the amount of surgery is limited.

“Over the last five years, there has been a push to do TLH, where the amount of surgery done through the vagina is actually minimized to next to nothing,” said Dr. Dennis McFadden, D.O., of Enid Women’s Healthcare Associates. “Since we have started doing these, we have had patients going home the next day. That is down from a two- to four-day stay.”

TLH is a procedure that allows doctors to detach the uterus from inside the body through laparoscopic instruments, while viewing the uterus, tubes and ovaries through a camera attached to a small telescope.

McFadden and Dr. David Ferguson, M.D., have been performing the procedure for about six weeks in Enid but already they have seen quite a turnaround for their patients.

With less hospital recovery time and minimal incisions, TLH is much more comfortable than other hysterectomies, McFadden said. Patients often are able to return to work or normal duties within two weeks.

The procedure can take up to about 2 hours and 20 minutes, but McFadden said he and Ferguson eventually expect to be able to perform the surgery in as little as 65 minutes.

McFadden said the doctor he trained under in Milwaukee, Dr. Charles Koh, has fine-tuned the procedure to where he has not had to surgically open a patient in nine years.

“He doesn’t get any easy cases,” Mc-Fadden said. “He has the ultimate team, and as we improve we expect similar results.”

During the procedure, the amount of bleeding can be lowered to 50 milliliters per patient, McFadden said. The average for other types of hysterectomies is between 150 and 250 milliliters.

“If there was some bleeding that couldn’t be controlled, these would actually have to be converted to abdominal case,” McFadden said. “I actually do feel like they are safer, because there is so much less incisions, but it is definitely not risk free.”

By the age of 60, one out of every three women in the United States has undergone a hysterectomy.

“There are many reasons a hysterectomy may be necessary,” McFadden said. “After all procedural and medical alternatives have been explored, some patients still require hysterectomies for bleeding abnormalities, chronic pain, pain with intercourse and pre-cancer conditions, just to name a few.”

There are three other forms of hysterectomies: supracervical, vaginal and abdominal. All hysterectomies help to reduce chronic pain, urinary problems and bleeding and fatigue issues. They also can help patients psychologically and sexually.

The TLH procedure takes a different approach to hysterectomy surgery, though.

McFadden said a supracervical hysterectomy is very similar to the laparoscopic surgery, with the exception that surgeons remove the cervix with laparoscopic surgery.

“This is beneficial, to go ahead and remove the cervix, because there is no source for potential cervical cancer that remains or cyclic bleeding,” he said.

Patients with significant pelvic scar tissue and endometriosis can have the laparoscopic surgery done to remove the diseased tissue before a vaginal hysterectomy is performed. This will help to reduce the risk of damage to the bladder and intestines.

For patients with large fibroids that are difficult to remove, laparoscopic surgery can allow the surgeon to detach the blood vessels to the uterus through the laproscope. This allows the surgeon to remove the uterus through the vagina with minimal bleeding.

Not all patients qualify for the TLH procedure, McFadden said.

Generally, doctors will shy away from any hysterectomy for younger women. Obesity also can prevent woman from having the procedure done. McFadden said the age limit is the same as any other hysterectomies, and patients must be in good health.

“Anybody who is not healthy enough to undergo general anesthesia would definitely not be a candidate,” McFadden said. “There are some surgeries where we can do regional anesthesia, but this is not one of them.”

McFadden said they can perform the procedure for pre-menopausal women, in which case they try to leave the ovaries in the patient. He said, though, those women can no longer get pregnant once the procedure has been done.

McFadden and Ferguson have had quite a bit of success with the procedure, thus far. McFadden said one of the women they performed the procedure on had a very bad case of endometriosis. The patient was nervous about the hysterectomy. Her pain had gotten so bad, she knew she needed to have the surgery. The doctors were able to perform the surgery, and she went home the next day.

“She was expecting the worse,” Mc-Fadden said. “She was expecting to be in the hospital for four or five days and have lots of complications. We were able to perform her surgery in this minimally evasive surgery and get her home.

“She was very pleased.”