Excessive Menstrual Bleeding: Treatments & Surgical Options
Some common treatments and surgical options for women diagnosed with excessive menstrual bleeding include:
Your doctor may recommend you take hormones such as progesterone or the birth control pill to control and regulate your period. Hormone therapy can limit the swelling of your endometrium (uterine lining that sheds each month during your period) and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery.
Surgical procedures include endometrial ablation, endometrial resection and hysterectomy.
Energy is used to destroy the endometrial lining of the uterus with the goal of lightening or stopping your periods. This technique is usually done on an out-patient basis and is generally not recommended for women who may want to get pregnant.
Endometrial resection refers to the surgical removal of the uterine lining. This procedure is also not recommended for women who may want to get pregnant in the future.
Hysterectomy refers to the surgical removal of your uterus. Any visible growths will be removed and, depending upon your condition, your doctor may also remove your fallopian tubes and ovaries. Based on your condition, there are several approaches to hysterectomy that your doctor may discuss, including:
With open surgery, a large incision is made in your abdomen – large enough for your surgeon to fit his/her hands and instruments inside your body. Open surgery allows your surgeon to see and touch your organs and has been used worldwide for generations, but for patients, this surgical approach may mean a long hospital stay and lengthy recovery.
Minimally Invasive Hysterectomy Options
Vaginal Hysterectomy – With vaginal hysterectomy, the uterus is removed through the vagina, without any external incision. Surgeons may use this minimally invasive approach if the patient’s condition is benign (non-cancerous), or when the uterus is a normal size and the condition is limited to the uterus. With vaginal hysterectomy, surgeons are challenged by a small working space and lack of view to the pelvic organs.
Laparoscopic Hysterectomy - During a traditional laparoscopic hysterectomy, long and thin surgical instruments are inserted through a few small incisions instead of a large open incision. One of the instruments is a laparoscope – a lighted tube with a camera at the end. The camera takes images inside the body and sends those images to a video monitor in the operating room. The monitor guides surgeons as they remove your uterus.
da Vinci® Hysterectomy: - With the da Vinci System, surgeons make just a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your doctor to operate with enhanced vision, precision, dexterity and control.
da Vinci is a minimally invasive approach that uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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PN 1002177 Rev A 04/2013