Robotic hysterectomy and tummy tuck

Combination procedures are nothing new. Breast augmentation with a tummy tuck is a mommy makeover. Facelift with upper eyelid lift for facial rejuvenation. But combining procedures between completely different specialties is less common. In this case, we’re referring to a hysterectomy and tummy tuck. This is a potential combination procedure.

Combining a hysterectomy and tummy tuck

As a woman gets older, she may develop a fibroid which is a benign muscular tumor of the womb, aka the uterus. This can result in a bloated abdomen, pain or irregular bleeding not necessarily associated with the menses. The treatment in many cases is a hysterectomy, or the removal of the uterus. As an aside, the ovaries can be left in place to avoid premature menopause.

So it’s not unreasonable to consider returning a woman’s abdomen to its pre-pregnancy shape with a tummy tuck at the same time as a hysterectomy. There are various ways to perform a hysterectomy these days. If performed through a lower abdominal incision, the hysterectomy can be done through the same incision as a tummy tuck. But there are instances where a hysterectomy is done without a lower abdominal incision. This includes removing the uterus through the vagina. Or laparoscopically through small incisions in the abdomen with the use of long thin instruments and a camera.

Regardless of which method is utilized, the plastic surgeon can perform the tummy tuck after the uterus is removed. Just as the surgeon “marks” the patient before an isolated tummy tuck, it’s also critical to mark the patient prior to the combination procedure.

It’s important that the OR staff, in the process of prepping the patient with betadine at the beginning of the operation, doesn’t remove the proposed tummy tuck markings. If that were to happen, the plastic surgeon would be at a loss as to where to make the incision since the skin shifts from standing preop to laying down during the procedure.

Will insurance cover a hysterectomy and tummy tuck

While your insurance typically covers a hysterectomy, you still may have out of pocket costs if you haven’t met your deductible. But no part of your insurance will cover the tummy tuck. It gets even more complicated than that.

Insurance can cover the hysterectomy costs. These include the surgeon’s fees, the operating room costs and the anesthesia fees. The tummy tuck costs include the surgeon’s fees. But that may be the least expensive part of this operation. Since the operation occurs at a hospital, the patient will also be responsible for the OR and anesthesia fees during the tummy tuck portion of the procedure.

Just because the procedures occur during the same operating room and anesthesia “event,” they’re not all covered by insurance. For example, once the hysterectomy ends and the tummy tuck begins, the clock also begins for the tummy tuck. Insurance won’t cover the time necessary to perform the tummy tuck. Those costs must be paid out of pocket by the patient. More importantly, the OR fees and anesthesia fees are way more expensive than those same fees when the procedure is performed in a doctor’s own office-based operating room.

A hospital is the most expensive place to receive care. We just don’t realize it since insurance often covers a bulk of it. Not so with cosmetic procedures performed at a hospital. And even though you can contact the hospital in an attempt to determine the cost, you will still receive an erroneous bill. Guaranteed!

Occasionally after determining that a patient needs to have a hysterectomy, she will ask if a tummy tuck operation can be performed at the same time. Perhaps she’s been planning the tummy tuck anyway, it’s always been a thought in the back of her mind, or she believes that it’s a good opportunity to tighten her lower abdominal area. The short answer is a study has shown that a tummy tuck, or abdominoplasty, and a hysterectomy can be performed at the same time; however, you should be aware of some considerations.

First, you should understand both procedures. During a hysterectomy, Dr. Jenkins of Jenkins Obstetrics, Gynecology and Reproductive Medicine surgically removes a woman’s uterus, the part of the body where a baby grows during pregnancy. Hysterectomies are needed when a patient has abnormal bleeding, pain in the pelvic region, endometriosis, cancer, or uterine fibroids. The abdominal hysterectomy is the most common form of the procedure; however, the uterus can also be removed with laparoscopic surgery or through the vagina. The recovery time for an abdominal hysterectomy is much longer than that of less invasive procedures and typically leaves a scar that is several inches in length.

A tummy tuck is a completely different surgical procedure and would require a plastic surgeon. During a tummy tuck, fat and excess skin are removed from the lower abdomen area. While it is not a substitute for healthy weight loss, it is helpful in removing loose skin and tissue.

Performing the surgeries at the same time could reduce overall time spent in the hospital, recovery time, and the risks associated with being put under general anesthesia since patients will only undergo one surgery. It could also save money. There are risks however. The study from 2012 found that 32% of the 65 women involved in the study had complications.

Robotic hysterectomy and tummy tuck

It might surprise you to learn that hysterectomies are the second most common surgery among women in the United States. And with obesity ever on the rise, many of the 500,000 women who get them annually wouldn’t mind getting some elective surgery done also, especially to reduce a hanging belly. Well who says you can’t have both?

A study published in Plastic and Reconstructive Surgery, the medical journal of the American Society of Plastic Surgeons, finds that a panniculectomy (from pannus or “hanging abdomen”) better known as a tummy tuck, can be performed at the same surgery as a hysterectomy without increasing the risk of complications.

“Performing a concurrent hysterectomy with panniculectomy does not increase the 30-day risk of reoperation or wound, medical or surgical-site complication.”

Using a national surgical database from 2005 – 2012 that included more than 25,000 women who underwent a hysterectomy, researchers identified just 174 patients who had a combined hysterectomy and tummy tuck and compared their 30-day complication rates to those who only had a hysterectomy.

The mean operating time was about 2 hours for a hysterectomy alone and about 4 hours for the combination surgery. Women having both a hysterectomy and panniculectomy were more often obese (BMI >30) with a history of a cardiovascular or respiratory condition.

Women undergoing the double procedure had a higher rate of blood clot-related complications called venous thromboembolism (VTE) at a rate of three percent versus one percent.

However, when researchers compared matched groups of patients with similar characteristics, they did not find a significant difference in VTE risk, wound complications, surgical site infections, medical complications, or total complication rate.

The only significant difference was the length of hospital stay, where women having both procedures were twice as likely to spend at least three days in the hospital.

If you’ve got a “stomach apron” and are slated to undergo a hysterectomy, here are a few more reasons why scheduling a tummy tuck at the same time might be right for you:

Between the surgeon, anesthesia, operating room fee, medications, and hospital stay, any kind of surgery is costly. But if you have a plastic surgery procedure like a tummy tuck done in conjunction with a hysterectomy, you can consolidate some of the costs. If you’re lucky, you may only have to pay for the surgeon and any additional operating room and recovery room time.

A hysterectomy is a major surgery that requires you to take time off from work and your regular schedule – 6 to 8 weeks on average for an abdominal hysterectomy, and up to two weeks for certain laparoscopic procedures. A tummy tuck is also a major surgery that requires anywhere from two to 12 weeks for recovery. Why not recover from both at the same time? This way, you won’t have to take double the time off from work or your daily routine.

Sure, you took some time to recover after medically necessary surgery, but why do you suddenly look so…good? Unlike rhinoplasty or a breast augmentation, a tummy tuck is easy to conceal, especially if you’ve had major abdominal surgery. People will notice a difference, but it can be your little secret!

Answers to Your Questions About Hysterectomy – From the American Congress of Obstetricians & Gynecologists

Childbirth, aging, genetics, and simply living life can affect the body and its appearance in a lot of ways, but there are things you can do to modify your appearance and feel more confident about the way you look. So if you can kill two birds with one surgery without increasing the risk of complications, why not?

David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.

what is the recovery time for a robotic hysterectomy

How long does a robotic hysterectomy take?

Your robotic hysterectomy surgery will be done using general anesthesia. A tube is inserted into the throat to give anesthesia and to help you breathe while you are asleep. You may also have a catheter tube placed into your bladder to drain urine during your procedure and after surgery. A robotic hysterectomy takes about 3 – 4 hours.

To start your surgery, we make your robotic hysterectomy incisions near your belly button. Next, we pump your stomach with gas to inflate it, so we have more room to see inside you and work efficiently. A laparoscope is inserted into your abdomen along with other surgical instruments. The surgeon then moves to the control area to remotely control your surgery. The uterus is cut into small pieces, so that it can be easily removed through these incisions.

Depending on the reason for your surgery, your entire uterus may be removed or just the portion above your cervix. Your fallopian tubes and ovaries may also be removed during your surgery. To finish your surgery, all incisions are closed and covered with small dressings.

What to expect after a robotic hysterectomy

After surgery, you will be taken to the recovery room for monitoring as you recover from your anesthesia. You will most likely stay in the hospital for a few days. Once you can go home, we will give you instructions to follow closely and a list of your follow-up appointments. We recommend keeping your incision areas dry for 2 – 3 days. Your bladder catheter will be removed in a day or two. You may have some vaginal bleeding. We encourage you to get up and walk as soon as you can, as this helps prevent blood clots from forming in your legs. We will prescribe you blood thinners to help prevent them too.

Complete recovery time from a robotic hysterectomy can take anywhere from a few weeks to a few months. Recovery after robotic hysterectomy is shorter and less painful than after a normal abdominal hysterectomy. Contact our office if you’re experiencing pain that isn’t relieved from medication, drainage, redness or swelling at your incision sites, fever, heavy vaginal bleeding, swelling in your legs, or chest pain.

Learn more about the benefits of a robotic hysterectomy

When you require a hysterectomy, our doctors at Professionals for Women’s Health can discuss the types of surgeries we offer to our patients of all ages. During your visit, we can also inform you of the benefits of having a robotic hysterectomy versus a traditional hysterectomy. To schedule an appointment to learn about how a robotic hysterectomy works, call our Columbus, Dublin, or Westerville, OH offices today.

robotic hysterectomy with large fibroids

A hysterectomy is a personal choice that can help to remove the symptoms of uterine fibroids. Board-certified doctor of osteopathic medicine and OBGYN Dr. Samantha Schoenhaus can now offer you a laparoscopic hysterectomy option. This means you can get a hysterectomy without the invasive nature of an abdominal incision. Schedule a consultation with Essential Women’s Health Associates in Las Vegas or Henderson, NV to learn how a robotic hysterectomy may be able to help you.

What are uterine fibroids?

Uterine fibroids are noncancerous growths that appear on the uterus; these can occur during the childbearing years. These growths can vary in size from a small seed to masses so large they can change the shape of your uterus. You may only have one, or you could be experiencing multiple fibroids at once. Fibroid symptoms can include, but are not limited to:

Menstrual periods lasting more than a week

Difficulty emptying your bladder

If you experience pelvic pain that does not go away, prolonged periods, bleeding between periods, or anemia, you should see a doctor. A hysterectomy provides a long-term solution to uterine fibroids. While doctors do not know the exact cause of uterine fibroids, there are a few risk factors, including hormones, genetic changes, and more.

What is a robotic hysterectomy?

A robotic or laparoscopic hysterectomy is a minimally invasive and effective option if you are looking for a hysterectomy. During this procedure, instruments are passed through small abdominal incisions. This gives Dr. Schoenhaus more precision and control over the procedure. There are many advantages to a laparoscopic procedure, including:

Quick return to normal activities

Hysterectomies are performed at a local hospital, and it normally takes around two hours. A hysterectomy can prevent uterine fibroids from returning and stop the symptoms of the disorder. Our office offers full and partial hysterectomies. This means you can choose to take out the entire uterus and ovaries or leave your ovaries in if you wish to. If you are considering a robotic hysterectomy, contact Essential Women’s Health Associates in Las Vegas or Henderson, NV to learn more about the procedure.

Reasons to get a robotic hysterectomy

There are multiple reasons to get a laparoscopic hysterectomy, and it may be able to stop your symptoms of uterine fibroids and remove pre-existing growths. This treatment can also be used to treat many other things, including:

Abnormal uterine bleeding

While a hysterectomy is an incredibly personal decision, Essential Women’s Health Associates are happy to offer this service to those in need. If your quality of life is in jeopardy because of women’s issues, our robotic hysterectomy may be a good option for you.

Where can I get a robotic hysterectomy in Las Vegas or Henderson, NV?

A robotic hysterectomy can effectively reduce your symptoms of uterine fibroids as well as removing the growths. Dr. Samantha Schoenhaus can help guide you through the process of your consultation, eventual surgery, and recovery. After your surgery, you will no longer have periods or become pregnant, and it could remove your fibroids and the symptoms that accompany them. Contact Essential Women’s Health Associates in Las Vegas or Henderson, NV for a full consultation on the state of your overall health.

how long does a robotic hysterectomy take

A hysterectomy — the removal of your uterus — is a major surgical procedure that triggers lasting physical changes. This surgery was traditionally done through an incision in your abdomen.

Technological and medical advances have taken some of the risk out of this surgery by allowing surgeons to remove your uterus through less invasive methods, specifically with a robotic procedure.

In this article, we cover what a robotic-assisted hysterectomy is like and how this procedure compares with a traditional or open hysterectomy.

A robotic-assisted hysterectomy still uses incisions in your abdomen to remove your uterus. But these incisions are much smaller than those used for a traditional abdominal hysterectomy.

Similar to laparoscopic surgeries, a surgeon will make small incisions to insert a tiny flexible camera and other surgical instruments. These incisions are much smaller than an incision made to directly remove your uterus but are still large enough to allow the surgeon to insert tools and detach your uterus.

If possible, your uterus itself is still removed vaginally to further minimize incision sizes and risks of other problems.

There are several types of hysterectomy that may be performed either by traditional or robotic-assisted means. They’re grouped based on how much of your uterus or your reproductive system is removed.

With any of these hysterectomy types, your fallopian tubes, ovaries, or both may or may not be removed.

Who needs a hysterectomy?

There are several reasons why a healthcare professional may recommend a hysterectomy for you. These include if you have:

Traditional hysterectomies require the use of large abdominal incisions to remove your uterus.

Robotic-assisted surgeries for procedures such as a hysterectomy aim to reduce your pain, risk of problems, and recovery time by making the surgery as minimally invasive as possible.

A robotic hysterectomy usually takes 3 to 4 hours. While this is longer than the typical 1 to 2 hours a traditional hysterectomy takes, the robotic technique usually results in shorter hospital stays and recovery time.

Overall, the path to your hysterectomy will be about the same, with preoperative tests and imaging to assess your health before surgery. These may include blood tests, a chest X-ray, and an electrocardiogram (CKG).

On the day of your robotic surgery, a few small incisions will be made near your belly button, and robotic tools will be used to cut and possibly remove your uterus instead of one large abdominal incision being used.

There are benefits and risks to each type of hysterectomy, but overall, these surgeries all carry a low mortality risk.

Out of all the hysterectomy methods, though, robotic-assisted hysterectomy is the safest, with a 77.6% survival rate after 5 years compared with 72.5% survival rates with an open hysterectomy.

How accessible is robotic surgery?

The healthcare services that are available where you live play a big role in your chances of having access to robotic surgery. But the use of these methods is increasing each year as the technology and training on these devices become more widespread.

In one 2021 study, researchers found that even traditional laparoscopic hysterectomies decreased from 62% to 29% of all hysterectomies, while robotic procedures increased from 26% to 61%.

Recovery times are individual to each person and the specific type of hysterectomy performed, but overall, robotic procedures decrease your recovery time, length of your hospital stay, blood loss, and risk of other problems over traditional hysterectomies.

The main driver behind improvements in recovery time and success is the size of the surgical incision. See comparisons below.

The potential risks of a robotic hysterectomy are similar to the other types of hysterectomy, including:

Talk with the surgeon before your procedure about your individual risk of problems. In some cases, a robotic or laparoscopic surgery may need to be changed to an open procedure.

The surgeon can go over your individual risk factors for this scenario.

How much does a robotic hysterectomy cost, and is it covered by insurance?

All things considered — factoring in procedure cost and hospital stay — a robotic hysterectomy is among the most affordable types of hysterectomy.

One study examining direct costs between 2015 and 2017 found that the average direct costs for each procedure were:

It’s also important to consider the differences in the length of hospital stays with each procedure, which were:

Many insurance companies and Medicare or Medicaid usually cover a hysterectomy that’s deemed to be medically necessary.

Coverage for elective hysterectomies and coverage for different hysterectomy techniques may vary by insurer. Call your insurance company before your procedure to verify any coverage restrictions or limitations.

What’s the difference between a robotic hysterectomy and a laparoscopic hysterectomy?

In a laparoscopic surgery, the surgeon directly controls the instruments used to complete the procedure. With a robotic technique, the surgeon will sit at a console, controlling a robot that performs the surgery.

Is a robotic hysterectomy considered major surgery?

A robotic hysterectomy is still considered a major surgery due to the fact that an entire organ (your uterus) is being removed.