Women's Health

Which Specialist Performs a Hysterectomy?

The choice of surgical specialist depends on the underlying condition of the reproductive system.

What Specialist Performs a Hysterectomy?

Key Takeaways

  • Which specialist performs the surgery depends entirely on the nature and seriousness of the underlying problem and the area of surgical expertise the problem requires.
  • Your best choice is a surgeon who combines knowledge, experience, and expertise in effectively tackling the underlying problem.

In the U.S., hysterectomies are second only to cesarean deliveries among the most widely-adopted surgical practices, and the number of women opting to go under the knife exceeds half a million annually. Your choice of specialist for the surgery depends entirely on the nature and seriousness of the underlying problem and the area of surgical expertise the problem requires.

Who Wields the Knife - General Surgeon or Gynecologist?

Every third American woman transitioning into senior citizenship will have elected to go for a hysterectomy to tackle problems affecting the reproductive system. Cancer of the reproductive organs is not as big a reason for a hysterectomy as non-cancerous vaginal bleeding, uterine masses (fibroids), and womb prolapse, which together account for almost 90 percent of all gynecological surgeries.

Both general surgeons and gynecologists are equally comfortable doing hysterectomies, but your best choice is a surgeon who combines knowledge, experience, and expertise in effectively tackling the core of your problem.

The Key Qualities That Should Help You Zero In on the Right Specialist

  • The surgeon is preferably a gynecologist specializing in treating patients with problems of the reproductive system.
  • His or her surgical expertise extends to the kind of problem that you are facing.
  • The hospital excels in the area of treatment that ensures the most favorable outcome for you, as evidenced by its past record.
  • The medical specialty and practices are covered by your insurance policy, and entail minimum out-of-pocket expenses.
  • The doctor is comfortable answering your queries and is good at treatment option strategies.

Abdominal and Vaginal Hysterectomy Performed by a General Surgeon or Gynecologist

The patient may be enjoying excellent health but is distressed by the severity of vaginal bleeding and painful menses, or has fibroids that are impacting her ability to bear children. For such women, the general surgeon would have adequate expertise to conduct the operation.

The open abdominal hysterectomy is the easiest method, enabling the general surgeon to access and remove the uterus while leaving the cervix and other supporting structures safely in place. In fact, this is precisely how many hysterectomies are performed in America.

The vaginal incision route for a hysterectomy is widely practiced when only fibroids need to be removed or when the uterus is small enough to be removed through the vagina. However, this procedure is avoided when cancer or endometriosis (a uterine outgrowth) complicates surgery.

Minimally-Invasive Hysterectomy – the Age of Laparoscopy

How Laparoscopic Surgeons Offer Less Intrusive Options

Many patients remain unaware that an abdominal hysterectomy can be substituted with less tedious and less painful options like laparoscopy. Ideally, the specialist one entrusts with the task of removing the uterus with or without supporting organs should be a surgeon with expertise in minimally-intrusive surgical practices.

The abdominal surgical route is normally taken when the reproductive system or a part of it is compromised by cancer or other complications like endometriosis, requiring a clearer view of the abdomen and direct access to organs. 

The laparoscopic surgeon who is well-trained, experienced in modern procedures, and has access to sophisticated equipment is in a position to tackle the complexities of surgery in a minimally-intrusive manner that relaxes the patient and ensures a speedier recovery.

Single-Incision Laparoscopic Surgery

Available today are more advanced forms of laparoscopy that involve single-incision surgery through the belly button, and this has become possible due to the miniaturization of surgical scopes, cameras, and other instruments.

Robot-Assisted Surgery

The robotic arm has considerably reduced the scarring, pain, and physical discomfort of surgical laparoscopy. As proof of this type of surgery's success, more than a million and a half operations have been performed using this technology.

Four Reasons for Choosing a Laparoscopic Surgeon

Choosing a laparoscopic surgeon is perhaps the easiest option for the patient, due to the following factors:

  • Incisions are smaller, thus causing less pain and discomfort.
  • Complications, especially the risk of excessive blood loss and peripheral organ damage, can be deftly avoided.
  • The patient can be discharged quickly after a 90-minute surgery followed by a short period of observation in the post-surgical recovery room.
  • The operation creates smaller scars that heal faster, and expert surgeons can place scars in abdominal tucks or skin folds to minimize their visibility.

Finding the Qualified Laparoscopic Surgeon Could Be a Chore

Looking at the unusually large number of hysterectomies conducted in the U.S. every year, it may come as a surprise that both general surgeons and gynecologists prefer abdominal surgery over laparoscopy, even though the latter is less stressful for the patient.

There are several reasons why laparoscopy is less in vogue:

•        The average gynecological specialist is more familiar with abdominal and traditional vaginal surgery, and has less exposure to and experience in doing a laparoscopy.

•        Laparoscopy requires expertise and specialized equipment that not all hospitals are able to provide.

•        The average gynecologist performs less than 20 hysterectomies annually, and laparoscopy requires specialists well-versed in the procedure, having had experience in at least 50 cases.

•        Many doctors emerging from residency courses are reluctant to explore laparoscopy as they have not undergone the additional two years of specialization in advanced laparoscopic surgery.

The Role of the Gynecological Oncologist

When cancer is suspected or diagnosed in the uterus, cervix, ovaries, or fallopian tubes, the services of an experienced gynecological oncologist becomes crucial.

  • Such a specialist is an obstetrician-gynecologist who has successfully completed a board-certified program and training specializing in various cancers that affect the female reproductive system.
  • Leveraging the services of such a specialist ensures that the entire process, from the diagnosis of cancer to strategizing solutions suited to your individual needs, the surgery itself, and follow-up action including chemotherapy, radiation, and palliative care, can be supervised by a single specialist doctor.
  • The specialist ensures that a complete or partial hysterectomy is performed carefully, minimizing the risk of cancer spreading to other organs. The oncologist would also be able to coordinate chemotherapy and radiation treatments to ensure that the surgery resolves issues successfully.

It is very important to have access to a gynecological oncologist from the beginning, because the suspicion of a cancerous mass or its confirmation through lab tests and imaging results lays the foundation for the first surgical procedure. The quality of the initial surgery and follow-up is a make or break moment that truly shapes the long-term effects the patient must endure.

The expert gynecological oncologist who has had substantial experience in treating various kinds of reproductive cancers is in the best position to choose the mode of treatment or surgery that is most appropriate to the individual.

Gynecological Oncologists Offer Expertise in the Following:

  • Carefully matching surgeries and combining chemotherapy and radiation correctly with each stage of the cancer.
  • Removal of tumors with minimum collateral damage to the adjoining organs.
  • In many hospitals, oncological surgery and medicine are handled by the same specialist, and this brightens the chances of recovery for the patient.
  • In certain cancers such as those affecting the ovaries, chemotherapy can be administered by such specialists directly to the affected cells, thereby limiting the side effects on the affected site.
  • The oncologist is better equipped to address all the needs of the woman including her childbearing capacity, sexual problems, emotional issues, and family interactions.