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Treatments for women safer, shorten recovery
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Patient Katie Morris talks to Dr. Keith Micetich during her appointment at Jackson Regional Women's Center. |
In the old days, if a woman needed a hysterectomy, the surgeon would make a large incision in her abdomen to remove the uterus. These days, surgeons make much smaller incisions in the abdomen and can even remove the uterus through the vagina. A two- to three-day hospital stay is now an overnight stay at the hospital.
In the old days, if a woman had other problems requiring surgery, she usually faced a longer hospital stay and recovery. These days, her surgery is most likely less invasive, resulting in shorter hospital stays and faster recoveries.
The old days were just 25 years ago, says Dr. Keith Micetich, an obstetrician/gynecologist at Jackson Regional Women's Center. He has seen dramatic changes in women's health care since he finished medical school in 1983 and his residency in 1988.
"Every procedure we do now is an old procedure done in a new way," he says. "How well and how safely we can do a procedure today is what has changed."
The introduction of the laparoscope — a surgical instrument with a small camera at the end — dramatically improved surgery options. With small incisions, the physician can insert the laparoscope to see what he is doing, rather than making large incisions.
A hysterectomy is a good example of the changes, Dr. Micetich said. Instead of making a large incision to remove the uterus, he uses the laparoscope and smaller incisions. In a process called morcellation, the uterus can be cut up into small pieces and removed through the small incisions. Or, he can remove the uterus through the vagina. The introduction of robotic surgery is changing the hysterectomy even more.
"The woman is going home the same day or the next morning," he said.
A newer way to do an ablation — which removes the uterine lining to prevent irregular bleeding — is even decreasing the number of hysterectomies needed.
"When I was in residency," said Dr. Micetich, "all we had was a D&C, dilation of the cervix and curettage, to scrape the lining and remove it. Now, I can use a hysteroscope to view the uterine wall, which is a safer way to see what we need to do. Rather than just scrape the lining, we can destroy it by freezing it or burning it with a probe so it does not come back. And, when the uterine lining is gone, you don't bleed again."
An ablation used to be a five-hour procedure in surgery; today it can be done in five to 10 minutes, he said. "It's an easy procedure that any gynecologist can do."
Bladder and uterine prolapse (loss of support) also can be corrected with better technology. "In the old days, we would use a patient's own tissue, either by realigning the tissue or harvesting tissue from another part of the body, such as the thigh, to provide support to keep the bladder or uterus in place," Dr. Micetich said. Today, he can use a synthetic mesh instead. Again, once was major surgery can now be done through small incisions in the vagina wall.
Even with the new technologies, he said, "we still have reasons to do all of these procedures the old way." Depending on the patient, a new procedure may not have the desired results. The old procedures still have their place, he added.
"Your physician should be able to do procedures several ways to be able to fine tune the procedure to your particular problem."
He opts for the newer procedures when he can. "They are safer and recovery is faster."
With all of the advancements with less invasive surgeries and small incisions, one important procedure hasn't changed. "I am sorry to say," he added, with a grin, "we have no new ways to deliver a baby. The baby will emerge either through the vagina or with a C-section."