Hysterectomy in Israel, Gentle Types of Surgery

Dr. Yakov Cohen

Head 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 Ichilov 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 can be performed without the need for surgical incisions or with minimal incisions.

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99%

successfully performed minimally invasive surgeries at the Top Ichilov clinic

88%

of patients returned to their usual lives after hysterectomy

98%

of patients underwent complete diagnostics in just 3 days

Table of Contents

Methods

Stages

Prices

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 Ichilov 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 to remove the uterus is oncological diseases of the organ. Benign tumors 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, and cervical cancer
• Extensive endometriosis
• Septicaemic endometritis
• Adenomyosis
• Benign tumors (myoma, uterine polyps, fibroma)
• Hyperplasia of the endometrial tissue
• 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 damage to the organ 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
• Hysterosalpingooophorectomy: removal of the uterus and its appendages, ovaries, tubes
• Radical: removal of not only the uterus 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 Ichilov 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. Let’s list the types of surgical interventions and discuss the features of their performance.

Abdominal Surgery. Open surgical intervention with a wide surgical incision on the abdominal wall. This type of surgery is inevitable if the patient has a large tumor or a pronounced adhesive 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 surgery, 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 skilled in all 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 marks on the abdomen after the surgery. The affected tissues of the uterus are excised, using an electroscalpel: 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 several centimeter-long incisions, 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 surgeon 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 Ichilov clinic also performs surgeries using a modified version of laparoscopy – SILS. This involves making only one incision 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 manipulator “hands.” They have greater freedom of movement in a confined space and can perform the excision of the organ with minimal trauma to healthy tissues.
RehabilitationAfter the surgery, the patient is monitored by doctors for some time. After minimally invasive surgeries, the hospital stay is from three days to a week, while after open surgery, it can be up to one and a half weeks. Full recovery takes from two weeks (after minimally invasive hysterectomy) to one and a half months (after open surgery). Patients are prescribed antibiotics, and sometimes hormonal medications (if the ovaries were removed).

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