Dr. Nisse Virginia Clark, MD, MPH

More and more, gynecologic surgery is moving towards the use of minimally invasive surgery. Minimally invasive surgery uses several small incisions and tiny tools and scopes to perform the operation, rather than one large opening. While it is not appropriate in every case, minimally invasive surgery can lead to less scarring, less blood loss, faster recovery, and a lower chance for infection. Minimally invasive gynecologic surgery may be performed with a laparoscope, a thin tube with a camera on the end that allows the surgeon to see inside the body. It may also be performed robotically, using even smaller tools and cameras that a surgeon controls from a computer. Robotic surgery allows even better vision, precision, and control than laparoscopic surgery.

Over the course of a lifetime, many women need pelvic surgery to stay healthy. Qualified gynecologic surgeons will have the right tools at their disposal to provide care with a minimum of discomfort.

It is important to note that having any of these conditions does not necessarily mean that a hysterectomy is necessary. There are other available treatment options in most cases.

Although the uterus is responsible for a period, it is the ovaries that control the hormonal changes that women go through every month. So if a woman has a hysterectomy but keeps her ovaries, she might still experience hormonal swings every month even if she no longer has a period. Alternately, if a younger woman has a hysterectomy where her ovaries as removed, she will essentially be in immediate menopause.

A hysterectomy can be performed traditionally through one large cut in the abdomen, laparoscopically using tiny incisions and small tools, or through the vagina. Full recovery may take four to six weeks. After a hysterectomy, patients might experience sexual changes such as vaginal dryness or a change in libido. It is common to experience strong emotions after a hysterectomy, including both grief and relief. If a patient's ovaries were removed, they may be at higher risk for certain diseases, such as heart disease and osteoporosis. Taking hormonal birth control might reduce this risk.

If surgery is necessary, hysteroscopy is often used along with laparoscopy, a kind of surgery performed through small incisions in the abdomen. Tiny tools are passed through the incisions, and the hysteroscope guides the doctors while surgery is performed.