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Health Team

New hysterectomy procedure doesn't leave scar

Posted November 12, 2009 3:50 p.m. EST
Updated November 16, 2009 3:02 p.m. EST

— Nearly a third of women in the United States have a hysterectomy by age 60. Doctors have a developed a new surgical method they say doesn't leave a scar.

The most common method for a hysterectomy is open surgery through a horizontal incision in the abdomen. Robotic and laparoscopic surgery work through several small incisions.

The procedures leave scars similar to a Ceasarean section. Additionally, the bigger an incision is or the greater the number of incisions, the longer recovery time is – up to six weeks after open, abdominal surgery.

Jennifer Russo, 36, needed a hysterectomy for persistent vaginal bleeding. Medications and cryoblation, or freezing uterine tissue, hadn't helped her.

Russo, though, thought she couldn't afford the long recovery time.

"I would have just suffered through it," she said. "I don't have six weeks to recuperate. And with having two boys, I would never put that kind of burden on my family."

Then, Russo met gynecological surgeon Dr. Craig Sobelewski. He offered to use a new technique, working through a small, hidden incision.

"It's a hidden scar, and it's frequently referred to as a scarless procedure, because it uses a natural scar, namely the belly button," described Sobelewski, who practices at Duke University Medical Center.

The single incision approach is made possible with two tools – first, a special sponge. "(The) lower portion fits through the incision into the abdomen, and then it gets compressed inside that 1-inch incision," Sobelewski said.

Through the plastic channels in the holes of the sponge, doctors insert special laparoscopes that can bend and reach into the uterus.

"By angulating the instrument, we can now get around the corners and access important structures," Sobelewski said.

The uterine tissue is removed vaginally.

Sobelewski told Russo she would have one overnight stay in the hospital and be back to normal in two weeks, rather than six.

"And it was true," Russ said. "Besides my belly button being a little bit tender, nothing else hurt."

The scarless procedure is relatively new, so it's in limited use. Sobelewski said he believes it will become more widely available around the country – and even might become the preferred method of doing hysterectomies.