No Safety Benefit Found in Use of Robot for Hysterectomy

Here is a recent article from Bloomberg News that suggests that robotic-assisted hysterectomies may not be much better for reducing complications than other forms of hysterectomy.  However, there is some disagreement on the type of patients that were studies and whether direct comparisons can be fairly made.  It seems to say there is less chance od needing a blood transfusion but more chance of pneumonia.  I was fortunate enough to not have had any complications after surgery, although I did need a blood transfusion prior to surgery.  What has your experience been with complications after a hysterectomy?  Feel free to post in the comments section below.
Surgery to remove the uterus using a $1.5 million robot from Intuitive Surgical Inc. (ISRG) doesn’t reduce complications and may raise pneumonia risk compared with conventional less-invasive techniques, according to a second extensive study to find no added benefit from the devices.

Researchers examined data from about 16,000 women who had hysterectomies for benign conditions in 2009 and 2010. The robot operations cost hospitals $2,489 more per procedure with a similar complication rate as the standard practice of removing the uterus with minimally invasive equipment, according to the study released in the journal Obstetrics & Gynecology.

“Unfortunately, the greater costs associated with robotic-assisted hysterectomy were not reflected in improvement in outcomes,” said researchers at the University of Texas Southwestern Medical Center at Dallas.

The results released yesterday are from the second large-scale research published this year to find higher costs with no added benefit for robotic hysterectomy. In February, Bloomberg News reported that U.S. health regulators were surveying surgeons on the robots following a rise in reports that included as many as 70 deaths since 2009. In July, Sunnyvale, California-based Intuitive said sales growth slowed in the second quarter and that it had received a regulatory warning letter concerning reporting issues for the devices.

Intuitive fell less than 1 percent to $384.52 at 9:52 a.m. New York time. The shares have declined 33 percent since Feb. 27, the day before Bloomberg News reported the Food and Drug Administration survey of surgeons about the products.

Top Product

The company’s da Vinci system, used in more than 1,300 hospitals, is its primary product. Revenue from the robot and related instruments and supplies generated $1.8 billion in 2012, Intuitive has reported.

In the study released yesterday, while patients who got robotic hysterectomies had a lower rate of needing blood transfusions, they had double the risk of getting pneumonia after the operation.

The pneumonia finding may be related to a trend toward a higher number of robotic hysterectomy patients needing intubation after their operation, the University of Texas Southwestern researchers wrote. Lengthy robotic operations with patients in steep head-down positions may result in fluid buildup in the airways, the authors suggested. The trend was not statistically meaningful.

No Benefit

The net result was no benefit in reducing complications for robotic surgery. The complication rate was 8.80 percent for robotic hysterectomy surgery and 8.85 percent for a standard minimally invasive hysterectomy, according to the study.

Intuitive Surgical, in an e-mail, said patients in the study getting robotic surgery tended to be older, heavier and had a higher rate of chronic conditions.

“Given these facts, it is likely that a substantial percentage of patients who received a robotic-assisted hysterectomy would have otherwise received an open hysterectomy,” Angela Wonson, a spokeswoman for the company, said in the e-mail.

In the study, which culled data from more than 800,000 hysterectomies, the complication comparison was based on a subset of patients with similar ages, obesity rates and health status.

With standard minimally invasive surgery, called laparoscopy, surgeons manipulate instruments through several tiny incisions in the abdomen while looking inside the patient through a camera called a laparoscope.

High-Definition Screen

Robotic surgery is similar, except that the surgeon sits at a console a few feet away and maneuvers robotic arms while looking into a high-definition display. Unlike the standard equipment, the robotic instruments have wrists, potentially enabling finer control and movement.

In February, a study in the Journal of the American Medical Association found that robotic hysterectomies for benign conditions cost hospitals $2,189 more per procedure than the same surgery without the robot. That research, which looked at data from 441 hospitals from 2007 to 2010, showed complication rates were 5.5 percent for the robot surgery and 5.3 percent for a less invasive hysterectomy.

Click here to see the original article.

The Beginning

Hmmm, this one sounds interesting…I’m curious how things turned out!

Tales from the Vault

After watching a certain celebrity on TV discussing her hysterectomy on live TV  I thought to myself hmm………..  Yes she looked great in her tight leather look pants and  superhigh heels  but she  had probably  spent hours in make up and hair and had a wonderful stylist to make her ready for the waiting viewers.  That is not the true face of hysterectomy  I am!!!!!

Let me introduce myself.  I am Sally and I am a 40-year-old mother of two boys who has just endured what I can only describe as the worst few week of my life!! Yes my life!!  I had a Total laparoscopic Hysterectomy at the beginning of September this year.  The reason I went ahead with this “Ahem” routine surgery is because I had a fibroid the size of a grapefruit in my uterus.  This is my story from the creation of the Vault through my recovery and onwards.

My journey…

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I’m running in what?

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So, tomorrow is my first 5k since my hysterectomy this June.  I have been running for the last 6 weeks with a group of friends and that has been really motivating.  However, the other thing that has been great about it is the weather!  We have had beautiful weather on all of our run club nights, which for October in Canada is far from guaranteed.  But that is all about to change tomorrow.  It’s been rainy and cold for the last two days and there is some nasty weather moving in: wet flurries, 5mm rain, high winds and 3 Celsius!  So none of my training has prepared me for this!  Now I know there are many runners who wouldn’t blink an eye at this – but that’s not me!  I really wish I didn’t have to do this.  However, that is where having a group of fellow runners really helps.  I know they’ll be out there tomorrow too and we’ll make it through and it will be one more thing that we have shared together.  But still, if Mother Nature had a change of heart, I would fully support that too!

My Open Letter to The World ~ Post Op

Ah, yes, dealing with needing the help of others…that’s a challenge! We always want to put on a brave face and not rely on anyone. Thankfully, I had dear family and friends who insisted on helping and I am so glad they did. I’m fully healed now thanks to their good care. And now, I really miss all of those wonderful meals everyone made for me!

Bittersweet Joy

IMG_2576Dear World,

Exactly one week ago I was sophisticatedely  hacked in to by three surgeons and a robot.  I know, it sounds like the start of a bad joke but it’s not.  It is true to life ~ I could not even joke about my cystoscopy/stint application/hysterectomy/appendectomy procedure if I wanted to.  Before I entered the ice-cold operating room, I was quizzed at least four times as to what procedures I was having done.  By Person #3, I was beginning to wonder if the test was for me or if they really knew what they were going in there to do.  Needless to say, the operation(s) went well.  Almost five hours later, I did not wake up too well to a very sore midsection which looks (to this day) very much like Frankenstein’s forehead.

This is the first day I’ve sat down to write thank you notes to my friends…

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An Aching in My Heart…Still Coming to Grips

Here’s a post that’s in contrast to yesterday’s. As I do more reading, I begin to see the vast spectrum on which hysterectomy stories lay. For me, I was very happy to have had the surgery and so much for me has improved since then. However, for many, this surgery represents loss, not only of a part of your body, but of things that will never be. Here’s one woman’s story of that.

Learning to Fight Like A Girl

I just looked at my calendar.

A year ago today, I had just finished the first third of my sandwich therapy, and was prepping for the awful feeling that was going to hit me in the next couple of days.

I am amazed that I am sitting here today, still in remission, and on the other side of that very horrible treatment.

This time last year, I was making plans for my impending radiation therapy.  I was getting ready to return to work for a brief respite between chemo treatments.  I was under the mistaken impression that radiation was going to be easier on my system.  I was just learning to deal with hot flashes, and how to cope with the end of my fertility.

Here I am a year later.  A survivor.  Thankful to be on this side of treatment.  Thankful for remission.  Thankful that my life, for all…

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My Own Process

A story about one woman’s experience with hysterectomy. She does discuss her experience of having one child and if this is something that is hard for you to read, you may want to skip it. Check in tomorrow though for a posting from a woman who was not able to have children before her hysterectomy.

Finding Hope In Change

Lately I have been reading a lot of blogs about hysterectomies because I want to know how others are recovering from the surgery and what they’ve experienced along the way. These blogs are written by women who have this surgery prophylactically (preventatively) or because of medical necessity (fibroid tumors, cancer, etc.). Some of them still have their ovaries so their recovery is different than what I’ll be experiencing because they aren’t going through menopause. It’s still helpful to read their blogs because they detail what it’s like to be limited with movement, restrictions on lifting items over a certain weight and other physical challenges.

They’re also, often times, in their 20’s and 30’s, childless, and struggling with the realization that they can never carry a pregnancy. Maybe they are newlyweds and had been waiting a few more years before starting a family. Maybe they are single, still looking for a partner, and weren’t quite ready to have a baby…

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Hysterectomy Does Not Increase Risk of Cardiovascular Disease, Study Finds

blog pic 25Here is some good news for those of you needing a hysterectomy (or who have already had one).  Contrary to earlier reports, it seems like there is not a link between having a hysterectomy and an increase in cardiovascular disease.  Read on for more information about this recent study.

May 14, 2013 — Having a hysterectomy with or without ovary removal in mid-life does not increase a woman’s risk of cardiovascular disease compared to women who reach natural menopause, contrary to many previously reported studies, according to research published online today in the Journal of the American College of Cardiology.

“Middle-aged women who are considering hysterectomy should be encouraged because our results suggest that increased levels of cardiovascular risk factors are not any more likely after hysterectomy relative to after natural menopause,” said Karen A. Matthews, PhD, lead author of the study and a distinguished professor of psychiatry and professor of epidemiology and psychology at the University of Pittsburgh.

Hysterectomy is the surgical removal of a woman’s uterus; it is sometimes accompanied by the removal of the ovaries to decrease the risk of ovarian cancer. Hysterectomy is a common surgical procedure for women, but the benefits must be weighed against potential long-term related health consequences. Cardiovascular disease is the number one killer of women and many studies have shown increased risk of cardiovascular disease to be a health risk associated with hysterectomy, especially accompanied by ovary removal. Researchers in those studies usually evaluated cardiovascular disease risk factors years after hysterectomy and/or ovary removal and did not assess individual risk factor levels pre-surgery.

For this study, investigators followed 3,302 premenopausal women between the ages of 42-52 for 11 years who were enrolled in the Study of Women’s Health across the Nation (SWAN). Researchers compared cardiovascular disease risk factors in women prior to and following elective hysterectomy with or without ovary removal to the risk factors prior to and following final menstrual period in women who underwent natural menopause.

This is the only multiethnic study that has tracked prospective annual changes in cardiovascular disease risk factors relative to hysterectomy or natural menopause.

Investigators found that several cardiovascular disease risk factor changes differed prior to and following hysterectomy, compared to changes prior to and following a natural menopause, but those changes did not suggest an increased cardiovascular disease risk following hysterectomy, independent of body mass index, which did increase after hysterectomy with removal of ovaries. These effects were similar in all ethnic groups in the study.

Dr. Matthews said it is unclear why this study’s findings differed from other studies exploring hysterectomy and cardiovascular risk, but likely factors include the age of participants since hysterectomy that occurs earlier in life may present more cardiovascular risk. Also, earlier studies included women who had hysterectomy for any reason, whereas the SWAN study excluded women who had hysterectomy because of cancers.

“This study will prove very reassuring to women who have undergone hysterectomy,” said American College of Cardiology CardioSmart Chief Medical Expert JoAnne Foody, MD, FACC. “As with anything, if a woman is concerned about her risk for heart disease she should discuss this with her health care provider.”

Found at: http://www.sciencedaily.com/releases/2013/05/130514185330.htm