Da Vinci Surgery-Hysterectomy Via Robotics

For the last three years or so I've had chronic pelvic pain and my periods have gotten worse and worse. I stopped having vaginal intercourse with my husband because I was afraid of the pain I would experience during and after sex.

To back up a bit, when I was 13, I underwent the McIndoe surgical procedure where surgeons' created a vagina after it was discovered that I was born without one (congenital vaginal agenesis = absent vagina).

Back then I was told I wouldn't be able to have children but the doctor was wrong and three months after I got married, I was told I was pregnant. Nine months later I was blessed with a miracle baby through a planned cesarean. Since then I have had an ectopic pregnancy in 1993 and have had several other vaginal or uterine surgeries for cysts and painful fibroids.

Recently, I went to see a new OB-GYN since my original OB-GYN surgeon had died of old age. Instead of seeing a doctor, the office set me up with an appointment with a mid-wife and I told her what was going on but I don't think she really comprehended the issue.

This lady tried to do a pap smear on me but she couldn't find my cervix and the exam was so painful she suggested I go see an OB-GYN oncologist. When I explained to her that I hadn't been able to have vaginal intercourse in several years she just said, "you don't use it, you lose it" which I thought was pretty callous given my history and the fact that the pain was why I wasn't using "it".

Since I was still menstruating my concern was that I would end up back in the emergency room as I had originally as young teen, almost dying from the infected blood pooling inside of the uterous.

Anyway, she referred me to Dr. Beth Nelson who is affiliated with St. Francis Hospital in Hartford, CT. When I met Dr. Nelson she also tried to do an internal exam on me and I was so narrow and in such pain that she suggested that the only way she could see what was going on inside me without hurting me was if she performed a laparotomy.

I told her about my painful periods and suggested if I was going to undergo surgery anyway, it might be time for me to have a hysterectomy. I had tried to request that before but was told no because I was too young. Now at age 45, I was starting to go through menopause and I was very clear that I'm almost retired, I don't want any more children.

Dr. Nelson explained to me the pros and cons of having a hysterectomy and I agreed that I was ready to do it. She also explained that new operating technology was available that included using robotics that would reduce my pain, reduce blood loss and need for transfusions, reduce the risk of infections, reduce my hospital stay and I would have minimal scarring. I agreed that I wanted to have her operate and it sounded to me like the da Vinci Hysterectomy was the way to go.

She told me she would perform biopsies on the nodes, fibroids and anything else she found that was odd. She expected she would also have to do some reconstruction given my history and possible scar tissue build-up.

She set up surgery for the 2^nd week in July. The day came and my mom brought me in. After they stuck me with two IV's and brought me to the pre-op area, the anesthesiologist refused to put me under because I was wheezing badly from my 30 year smoking habit.

The anesthesiologist explained to me that with the da Vinci surgical procedure I would be put on an operating table that would be set at a 15 degree angle where my head would be down and my feet would be elevated. Gravity would help the surgeon by keeping my body parts in the right places however it would also affect my lungs and breathing capacity, particularly if I was congested.

The anesthesiologist felt that if I went through surgery at that time I wouldn't make it, or if I did, I would end up in the ICU. He refused to take the chance and I was devastated. I was worried about my COBRA health insurance running out and me not being in a position to be able to afford the surgery. I begged him to let me go but he did his job and took the safer approach by demanding that I quit smoking. I yelled at him and said I would not, but then I backed down and said I would try to cut back.

Dr. Nelson and various staff did their best to console me, but I was feeling angry at myself and guilty for wasting everyone's time. She agreed to reschedule the surgery as soon as it was possible and I agreed to get some help for my wheezing.

I tried to quit smoking using the patch on several days. I couldn't think, I couldn't write, I couldn't concentrate and I felt crazy. Then the first week in August I went on vacation in the mountains thinking I wouldn't smoke there, but I did. I came home from my family re-union and vowed I would quit smoking knowing that every day that was ticking by I was getting closer and closer to my re-schedule date. I knew I would be mortified if I showed up for surgery a second time and was refused.

My mother changed her summer plans and agreed that she would come back to take care of me as my husband hates hospitals and "female" business. Fortunately I managed to cut back on my smoking to around 1/3 of what I was doing prior to the last surgery date, and the day before surgery I didn't smoke or use the patch at all. I did jumping jacks the morning of surgery trying to kick start my lungs and I had used the inhalers and antibiotics I had been given faithfully.

The day of the operation we arrived at the hospital intake area on time. This time instead of hooking me up to two I.V's first, they ran an EKG and double-checked my breathing several times. Finally my nurse tried to hook me up and because she was rushing, popped a vein. With some help from a phlebotomist she was able to rig up both arms because with this surgery, you have to have two I.V. ports installed in case something goes wrong during surgery.

When they wheeled me into the operating room, I noticed about 10 people in there standing around waiting -with lots of equipment about the room. I actually made the comment, "is this a storage room?" but that was about the time that the sedatives put me down and I was out for the count.

The surgery was scheduled for 3-4 hours, but it actually took 4-5 hours because there was so much scar tissue from my previous surgeries that things inside weren't exactly how the doctor expected they would be. There was some reconstruction done and Dr. Nelson reported to my mother all had gone well.

I was in recovery for about 3 hours and by 5:00 pm I was in my hospital room for the night. My mom stayed long enough to advocate for my care because my IV had popped the vein and I was blowing up like a blow fish. Of course the medicine wasn't working and I was getting cranky.

After mom pointed out that one of my hands was swollen and the other wasn't, the nurse switched the IV ports and I was good again. She left for the night with both of us feeling exhausted but relieved.

Unfortunately I had a reaction to the pain medication that was given in the IV and I vomited that night and the following morning right after they gave it to me. I watched the clock tic minute by minute and I couldn't wait for morning so I could go home. I went in and out of sleeplessness.

They took my vitals every hour and they had these annoying leg cuffs that sound like someone clipping their nails, click, click, click, click, ratchet ratchet ratchet, click click click click, ratchet ratchet ratchet. I wanted out now but I had to wait until morning.

One of the doctor's came by and ordered the catheter removed and shortly after that, I begged the nurse to let me out of those anti-blood clot cuffs. Finally around 4:30am she said I could get up for 15 minutes. I never got back into bed after that because I was determined I was going home.

Dr. Nelson walked in around 6:00 am right after they had given me more pain medication and I was vomiting. I explained to her that I was feeling fine until they gave me the pain meds so she changed up the prescription. Unfortunately she told me she couldn't release me if I was vomiting. The nurse got me something for nausea and pretty soon I was feeling good again.

The Dr. came back through around lunchtime and told me I looked much better. I had managed to eat breakfast and had walked around the ward a bit. She agreed to release me and I was finally allowed to go home after lunch around 1:00pm.

When I had the surgery at age 13, I was in the hospital for 8 days and I had to have physical therapy to walk again after being in bed for so long. Atrophy sets in quickly so this was a huge difference from what I had experienced the last time.

Upon being released, I was instructed to lift nothing over 10 lbs and to not drive or do anything vigorous for the next 2-4 weeks. I also had to make a follow-up appointment for a month out for the doctor to check me prior to my attempting sexual intercourse again.

She gave me a prescription for ibuprofen for swelling and percasets for pain. It was also suggested I take a stool softener and gas medication as surgeries tend to cause gas and bowel problems for a few days.

A week later, I have minimal pain and am doing a lot of walking since that is about all I can do besides sit or lie down. But in just a few days, I'm surprised at how good I feel after having had the da Vinci Hysterectomy.

The best news was when the doctor's office called and said all my fibroids and nodes were benign. My incisions are healing nicely and although there is slight discomfort from the incisions, I stopped pain medication by day 5, and swelling medication by day six.

During my teen experience I was out of school for over a month and recovery was slow. This recovery has been fast and relatively easy. I would highly recommend considering robotics like the Da Vinci surgery if your doctor thinks it is an option. If you are in the Hartford, CT area, I would also highly recommend Dr. Beth Nelson. Her down to earth bedside manner, meticulous care and special attention to my questions was the absolute best I have ever received from a surgeon and I've been in and out of hospitals all my life.

Source:

http://www.davincihysterectomy.com/davinci_hysterectomy/index.aspx