Best of all, unlike many other women who undergo hysterectomies, Joffred and Rutt say they never had any serious pain.

Miraculous?

Hardly. As two Berks County, Pa., gynecologists pointed out at a recent public seminar, quick recoveries are the norm for women who can opt for a laparoscopic supercervical hysterectomy (LSH), the newest approach to performing this surgery that about 600,000 women in the United States undergo each year.

Their patients agree.

"Friends thought I would be out for six weeks," said Rutt, who lives in Muhlenberg Township, Pa.

"My recovery was a two-week period with minimal pain, and I just felt great the whole time," said Joffred of Mohnton.

The benefits accrue to the minimally invasive nature of an LSH, the doctors said.

"The recuperation time and level of invasiveness of this procedure are much less in this procedure than all the others," said Dr. Jeffrey B. Frank at the seminar, which was presented Nov. 28 at the Inn at Reading, Wyomissing.

"Today, a straight LSH can be done in 45 minutes to an hour," said Dr. Thomas M. Ebersole, also at the seminar. "You have a minimal risk of infection, you're eating that night, and you're going home soon."

The doctors explained that, in a traditional hysterectomy, the uterus -- and sometimes the cervix, fallopian tubes and ovaries -- are removed through an incision in the abdomen that is at least eight inches long.

In an LSH, the surgeon makes three to five small incisions about the size of a dime in the abdomen. Through these are inserted the laparoscope, a small television camera that Frank likened to an upsidedown periscope, and other surgical instruments.

The organs are then removed in sections.

Frank explained that most hysterectomies are performed to treat benign diseases: fibroids, which are benign lumps of muscles; abnormal bleeding, either during the normal menstrual cycle or at abnormal times; endometriosis (from growth of normal tissue in abnormal locations); and pelvic support problems such as prolapse.

Not all hysterectomies are best done as an LSH, said Frank.

"Cancers of the uterus and cervix are not treated with supercervical hysterectomies," Frank said. "They might be treated with a total laparoscopic hysterectomy (TLH), or a laparoscopically assisted vaginal hysterectomy (LAVH), depending on the particular malignancy."

A TLH involves removal of both the cervix and the uterus, Frank said, and an LAVH means removal of the organs through the vagina.

In both cases, he said, the ovaries and fallopian tubes may also be removed, depending on the patient's situation.

If malignancy is the indication for the hysterectomy, Frank said, it might be safest to proceed the oldfashioned way with an incision.

Frank and Ebersole pointed out that while all surgeons are trained in laparoscopy, not all of them possess the skill necessary to perform laparoscopic hysterectomies.

"We've been doing them for approximately three years," Frank said. "We had two years of training, and the procedure has been available nationally for about seven years in selected centers."

The doctors stressed that they are not giving women advice different from what their gynecologist told them.

"Every situation is unique," Ebersole said. "It comes down to each patient's history.

"Not everybody can have it."

Ebersole and Frank, who perform the surgeries in tandem, estimate they have done about 100 LSH surgeries since they started using the new procedure about three years ago.

While it uses more expensive equipment, the laparoscopic surgery takes less time, so it does not cost more than a traditional hysterectomy, he said.

"The risks, if an LSH is appropriate, I would say are less than a largeincision hysterectomy," Frank said. "They are certainly not greater."

Joffred and Rutt, who both suffered from painful conditions that were resolved by their hysterectomies, are glad they could have the new surgery.

"When Dr. Frank told me about the new procedure, I was really up for that one," Rutt said. "If women have a choice and they have that option, it's the best one."

Source: Reading Eagle, Pa. Distributed by McClatchy-Tribune Information Services. Powered by Yellowbrix.

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