April 11, 2003

The MGH Vincent Obstetrics and Gynecology Service continued the tradition ofadvancing minimally invasive gynecologic surgery when John Petrozza, MD, chief of the MGH Vincent Reproductive Medicine and In Vitro Fertilization (IVF) Division (right), recently performed the hospital's first total laparoscopic hysterectomy.

Two patients — including one who traveled from Ohio — now have benefited from the new procedure. According to Petrozza, hysterectomies typically have been performed through an abdominal or vaginal incision. Laparoscopy allows surgeons to perform surgery with minimal tissue injury by utilizing miniaturized video equipment and customized instruments. As surgeons became more comfortable with laparoscopy, it became possible to do the initial part of the surgery laparoscopically and then complete the case vaginally. Many physicians had questioned the benefit and cost effectiveness of this two-stage procedure.

Recently, laparoscopic surgeons began performing supracervical hysterectomies, removing the uterus but leaving the cervix in place. For some patients, however, it is medically necessary to remove the cervix. Now, a small but growing number of surgeons throughout the world, such as Petrozza, have been able to do an entire hysterectomy with removal of the cervix and ovaries through the laparoscope.

The procedure has proved to reduce the complications of more traditional surgeries and shorten a patient's recovery time to approximately seven days, as compared to four to six weeks for traditional hysterectomies. It also is cost-effective — reducing a patient's hospital stay from three days to one day.

"The new procedure is showing remarkable benefits," says Petrozza, who was appointed chief of the MGH Vincent Reproductive Medicine and IVF Division in January. "Historically, the MGH Vincent Service has been on the fast track of minimally invasive surgery. This procedure is just one way of keeping us there. From a clinical standpoint, I was just amazed how fast these patients recovered. One patient was shopping at the mall just five days after her surgery. When you look at overall outcomes, money saved and time in the hospital, the impact this procedure will have on a woman's life and on the resources of a hospital is tremendous."

For more information about this type of procedure, call (617) 726-8868.