Submitted Photo Dr. David Amsbury stands next to the da Vinci robot surgical machine.

There was a time when women undergoing hysterectomies could expect to spend three days in the hospital and be laid up at home for three weeks while healing from a sizable incision.

Today’s laproscopic surgery, using the robotic da Vinci system, has reduced the procedure to same-day surgery with only a week or two of down time.

“A lot of women just suffered from painful, cramping periods because a hysterectomy was a daunting thing,” said Dr. David Amsbury, obstetrician-gynecologist with Trinity Health, Minot. The da Vinci procedure changed all that.

“It really doesn’t disrupt your life very much. It empowers a lot more women,” Amsbury said. “They didn’t feel like they had really good options before.”

Da Vinci is a laproscopic, robotic surgery that offers more dexterity to the surgeon. Unlike a traditional laproscopic device, the da Vinci allows a surgeon to turn tools 360 degrees and move in areas that weren’t accessible in the past. The robot is attached to ports inserted through small abdominal incisions, and the surgeon sits in a separate area, operating the da Vinci with two joysticks and a console.

“I don’t even have to be scrubbed in any more,” Amsbury said. “It’s kind of like playing a video game. It’s a lot of eye-hand coordination.”

It’s the improved outcomes for patients that impress him, though.

Da Vinci dramatically reduces blood loss during surgery. Post-surgical pain is greatly reduced, with some women needing nothing more than extra-strength ibuprofen, Amsbury said.

“I see women back to taking care of their kids, running their homes, back to their jobs in a week or two with very little disruption, very little pain. It makes me a better surgeon. It gives the patient a better outcome. The da Vinci is not going anywhere. The proof is in what we see with patients. It’s safe, and it’s effective and it makes difficult surgery easier. It has been a game changer,” he said.

Da Vinci offers a surgical option that didn’t exist previously for severe scar tissue and large fibroids. Da Vinci also is used in a few other types of surgeries, particularly in urology in prostate or kidney procedures.

Hysterectomies aren’t the only options for women with uterine problems, however.

Improvements in medical procedures have made endometrial ablation, or burning of the inner lining of the uterus, a viable option for women suffering from heavy or irregular bleeding. It involves no incision, and provides an effective, temporary fix. Amsbury said use of the procedure has significantly increased in the past 10 years.

Another more commonly used option is uterine artery embolization, in which blood supply is cut off to fibroids so they shrink.

Educating the patient about options is an important part of finding an individualized solution, Amsbury said. Sometimes women postpone seeking help because they aren’t aware of the options or have misinformation about them, he said. For instance, a woman can be assured her hormonal balance won’t be affected by a hysterectomy, in which only the uterus is removed. Hormones are affected only if ovaries are also removed.

While technology is changing women’s surgical healthcare, increased knowledge about cancer has led to updated screening recommendations for women. One of the biggest changes in the past five years has been the revision in the Pap smear recommendation from every year to every three to five years for low risk women, Amsbury said. Even with the change, the number of abnormalities diagnosed has remained constant, indicating the less frequent Pap smears are effective in identifying women who need more monitoring, he said.