Does your surgeon have a “pre-flight” checklist?

An interesting article from Reuters UK today, revealed:

A simple checklist to confirm a patient’s name, what procedure is to be done, check allergies and count needles and sponges to make sure nothing got left inside halved the rate of surgery-related deaths, doctors reported on Wednesday.

In this study, the rate of complications fell from 11 percent to 7 percent.

Apparently, there was a great deal of reluctance among surgical teams to comply with the checklist experiment. But the results were so positive that many teams have come on-board with the practice.

If you have a choice of surgeons, this could be a good question to ask during your pre-op appointment.

Dr. Gostout says:

The preferred means for removing uterine polyps is through the outpatient procedures of hysteroscopy, curettage (often referred to as “D&C,” for dilation and curettage), or, increasingly, the two methods in combination.

In a hysteroscopy, the doctor inserts a thin, flexible, lighted scope (hysteroscope) through the vagina into the uterus. This technology not only allows the doctor to examine the uterus for the presence of polyps but also makes it possible to remove them at the same time, as long as they’re not too large. He or she does the excising with tiny cutting instruments inserted through the hysteroscope.

The time-honored D&C is still the method of choice, especially for larger polyps.

Here’s the Q&A on uterine polyps and here’s a more comprehensive article.

The technique — called “focused ultrasound ablation” — combines two well-established medical technologies, ultrasound and MRI.

Recovery time is minimal. Think two days, compared to 6-8 weks with a total abdominal hysterectomy.

Because the technique is so new, side effects are still unknown, and one-third of the women who undergo the procedure come back for a second session later.

For more info:

• See this article by Chicago’s ABC7
• Browse the system developer’s site

Think of EFT as acupuncture without needles: While thinking about a negative emotion or situation, you stimulate energy meridian points on your body by tapping on them with your fingertips.

When I first learned of EFT about seven years ago, I tried it briefly, then dismissed it as goofy and useless. Why I changed my mind is a story for another day.  

What is so intriguing about the EFT phenomenon is how many thousands of ordinary people are reporting success with this simple technique, for problems large and small.

Anyway, back to your pre-surgery fears. Here are the links to three stories at the EFT site:

Relief through EFT on the day before surgery

Surgery Anxiety and EFT

Tapping for Someone Else Who is Anxious About Surgery

And here’s now EFT founder Gary Craig introduces the first anecdote:

Early this morning I phoned Eric Robins, MD, a surgeon with a Kaiser Hospital in Southern California, to ask about the anxieties people face before going into surgery. In Dr. Robins’ experience, 80-90% of all surgery patients have noticeable anxiety before the operation–some of it quite severe. If this anxiety could be reduced or eliminated, he thinks that the amount of anesthetic required would be substantially decreased. Patient comfort, of course, would be enhanced as well.

… Someday, maybe hospitals and surgeons will consider tapping prior to every surgery.

In the meantime, you can either look for an EFT practioner near you, or learn the simple technique yourself and begin practicing it in your time before surgery.

Take a look at this: a 1,200-pound, million dollar robot that assists at laparoscopic hysterectomies.

Out of 600,000 hysterectomies performed each year in the U.S., just one out of 10 are laparoscopic-assisted vaginal hysterectomies (LAVH) — a much less invasive procedure than the TAH (total abdominal hysterectomy) performed on the majority of patients.

One of the key reasons why more women don’t receive the less invasive procedure is because of a long and difficult learning curve for surgeons.

The da Vinci(R) Surgical System hopes to remedy that difficulty. Robot-assisted surgery offers surgeons a way to perform finely controlled movements, while operating through a magnified 3-D view of the surgery site.

The robot’s camera and instruments are inserted in three or four inch-long slits in the abdomen (compared to a single 6-7-inch opening for a TAH). Doctors say that using the system is “like playing a video game.”

According to the system’s manufacturer, potential patient benefits include:

• Shorter hospital stay
• Less pain and scarring
• Less risk of wound infection
• Less blood loss and fewer transfusions
• Faster recovery
• Quicker return to normal activities

You can watch short videos on the system here, here and here.

So what do you think? Does robotic surgery make sense to you?

Not so, of course. For instance, recently the British press reported that Camilla, Duchess of Cornwall had made a full recovery after a “routine hysterectomy” on March 5.

The Duchess spent a week in hospital and was advised to rest and avoid strenuous activities and heavy lifting for at least a month.

Six weeks later, Camilla “strolled for hours with a wooden crook for support” on an eight-mile country walk on the royal Scottish estate of Balmoral.

We wish her a continued strong recovery.

Well now you can, according to a new study released this month by researchers at the University of California, San Francisco.

The four-year study confirms a widely held belief in gynecology: “The more symptoms of discomfort a woman has, as well as the longer she has tried alternative therapies unsuccessfully, the more likely she is to have a hysterectomy.”

The three predictors are:

1. Multiple symptoms (for example, symptomatic fibroids or multiple pelvic symptoms)
2. Other treatments that do not bring relief (for example, myomectomy  or endometrial ablation)
3. Previous use of gonadotropin-releasing hormone (GnRH agonists) to induce medical menopause

Having just a single symptom (such as heavy bleeding) results in only a 20 percent change of undergoing a hysterectomy. But having a combination of symptoms plus the other two predictors leads to an astonishing 95% chance.

According to Dr. Lee Learman, the lead investigator in the study:

That, in turn, means women with a high likelihood of hysterectomy can avoid years of pain and discomfort while trying other options first and women with a low likelihood of hysterectomy can explore other options with more confidence of their success.

You can learn more about the study here and here.

Over to you now…. Will this news have an effect on your decision?

There is no doubt that many women undergo the surgery unnecessarily, and still others who delay it longer than they should, fearing the consequences.

For women who are absolutely certain that a hysterectomy is right for them, I’ve written The Worried Woman’s Guide to a Happy Hysterectomy, to help you prepare well and recover well.

This blog, though, is to introduce you to the ongoing research and news and alternatives so that you can make an informed choice about your own treatment.

Watch for upcoming post on “Hysterectomy by Robot?” and a new study that predicts who will — and won’t — eventually have a hysterectomy.

We’ll talk soon….

Sheila