Dr. Yakov Cohenhead of the endoscopic (hysteroscopic) service of the obstetrics and gynecology department
There are diseases of the female reproductive system for which the most optimal treatment option is the removal of the organ, either subtotal or total. Hysterectomy in Israel at the Top Ihilov clinic is performed according to new standards that imply minimal risks of complications and a short recovery period. Depending on the indications and extent of the pathology, the surgery may be performed without the need for surgical incisions or with minimal incisions.
The most gentle option for performing a hysterectomy is robot-assisted surgery, during which blood vessels and nerve endings are minimally damaged, and the risks of medical errors are reduced to zero. If after a classical hysterectomy with extensive tissue excision the recovery period is from one month to one and a half months, then after minimally invasive surgery, patients can be discharged from the hospital and return home within a few weeks. The Top Ihilov clinic strictly adheres to safety and comfort requirements. The attentiveness and high professionalism of the clinic's medical staff help avoid complications in the postoperative period. Therefore, reviews of hysterectomy in Israel are mostly positive.
Indications for Hysterectomy
The most common reason for the need for a hysterectomy is oncological diseases of the organ. Benign tumours are usually removed while preserving the uterus, and only if the neoplasm shows rapid growth is it removed along with the organ. However, there are other diseases for which doctors prefer to remove the uterus if other treatment methods are deemed ineffective. In particular, indications for hysterectomy may include the following diseases:
- Uterine, ovarian, cervical cancer
- Extensive endometriosis
- Septicaemic endometritis
- Adenomyosis
- Benign tumours (myoma, uterine polyps, fibroma)
- Hyperplasia of the endometrial tissues
- Prolapse or advanced stage of uterine descent
- Tuberculosis of the fallopian tubes
- Heavy and frequently recurring uterine bleeding.
How Hysterectomy is Performed in Clinics in Israel
Depending on the degree of organ damage and the extent of the pathology, the following types of hysterectomy are distinguished:
- Subtotal: only the uterus is removed, the cervix is not removed
- Total: both the uterus and cervix are removed
- Hysterosalpingo-oophorectomy: removal of the uterus and its appendages, ovaries, tubes
- Radical: not only the uterus is removed but also part of the vagina, lymph nodes, adipose tissue, and appendages.
Once the doctors have determined the type of hysterectomy to be performed, they begin to consider various options for conducting the surgery. At the Top Ihilov clinic, preference is given to minimally invasive techniques, but sometimes, to save the patient's life and ensure her recovery, an open surgery must be performed. We will list the types of surgical interventions and discuss the features of their implementation.
Abdominal Surgery. Open surgical intervention with a wide surgical incision on the abdominal wall. This surgery is inevitable if the patient has a large tumour or a pronounced adhesions process. Since the surgeon has the opportunity for a visual overview of the affected tissues, he can assess the extent of the pathology and see features that could not be identified during diagnostics. During the operation, a tissue sample may be taken for histological analysis (biopsy). If necessary, intraoperative radiotherapy may be performed – irradiation with ionizing rays. The surgery is performed by highly qualified surgeons who possess all the necessary surgical techniques.
Transvaginal Hysterectomy. The least invasive option for performing the surgery, it is most often performed when the patient is diagnosed with uterine prolapse. Access to the area of pathology is achieved through an incision in the vagina, so there are no visible scars or sutures on the abdomen after the operation. The affected tissues of the uterus are excised, and an electroscalpel is used: this instrument allows for the cauterization of blood vessels immediately after tissue excision, preventing significant blood loss. The recovery period after such surgery takes minimal time.
Laparoscopic Hysterectomy. The most commonly performed surgery, it allows for the removal of the uterus through small incisions in the abdominal wall. Surgical instruments are inserted through incisions of a few centimeters, and a laparoscope – an instrument that illuminates the area where the intervention will take place and transmits its image to the surgeon's monitor – is brought to the operating area. The doctor does not have direct visual contact with the area being operated on; all manipulations are performed by monitoring them on the screen. An undeniable advantage of this intervention is the absence of significant blood loss, minimal risk of infection, and a short recovery period after the surgery. Currently, the Top Ihilov clinic also performs surgeries using a modified version of laparoscopy – SILS. This involves making only one puncture in the abdominal wall, near the navel. After such surgery, there are no noticeable scars on the body.
Robot-Assisted Hysterectomy. A new format for performing hysterectomy made possible by the advent of innovative robotic equipment – the da Vinci robot. Surgeries that were previously impossible to perform laparoscopically due to limitations in the movements that the surgeon could make are now done minimally invasively. Instead of the surgeon, all surgical actions are performed by the robot's