Burke County OB/GYNs Leading Western NC in New Procedure

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BY TONY GLENN
BLUE RIDGE HEALTHCARE

MORGANTON - In western North Carolina, Burke County may be on the forefront of a new trend in gynecological surgery for hysterectomy. Six OB/GYNs now offer the latest minimally invasive procedure - Total Laparoscopic Hysterectomy (or TLH).

As in other laparoscopic procedures, TLH is performed entirely inside the abdomen through tiny incisions rather than through a large open incision. This approach usually lessens the chance of complications, and the body is able to heal much faster. The uterus and the cervix are removed in small pieces through one of the small openings.

“Most of my patients would prefer to have the TLH procedure rather than other methods of hysterectomy,” said OB/GYN Mohammed M. Mohiuddin, MD, who practices in the Valdese area.

“The main reasons why are that they are having less pain and are recovering faster,” he continued. “They get back to their normal life much quicker. There is less tissue dissection, which in faster recovery.”

David W. Kirk, MD, is another OB/GYN who performs TLH. “I would say the vast majority of the hysterectomies I perform now are TLH,” Kirk said. “It allows for a much shorter hospital stay, and the patient starts feeling better faster.”

He noted that studies have not shown any difference between the ultimate outcome of the various options for hysterectomy.

“The problems that necessitate hysterectomy are cured whether the operation is performed vaginally, abdominally or laparoscopically,” Dr. Kirk said.

He offers patients who need hysterectomy the various options, but more and more frequently they choose the TLH procedure.

“I don’t perform it on women who have problems that would make the procedure inappropriate,” he said.

OB/GYN Howard Hall, MD has performed more than 200 TLH procedures, and is finding it increasingly more suitable for his patients.

“Several years ago, most gynecologists wouldn’t have considered performing TLH on a patient who had previously had a C-section,” Dr. Hall said. “Today, that’s no longer the case; in fact, we’ve performed TLH’s on women who have had as many as four prior C-sections. I am now using this approach in situations I wouldn’t have previously attempted even a year ago.”

However, not every hysterectomy can be done laparoscopically, said Dr. Mohiuddin. “But patients who can have it can really benefit from it.”

Dr. Mohiuddin explained that some hysterectomies start as a TLH, then must be converted to an open procedure in mid-operation. “Sometimes we find that after looking inside, it’s safer to perform the open procedure. So from the start we make the patients aware of that - but the conversion rate is very low.”

Dr. Hall’s conversion rates from TLH to the open procedure have shown continued progress as he has gained experience with the procedure.

“Our conversion rate for 2005 was 2%; 2006 was 1%; so far in 2007, it has been 0%,” Hall said.

Other local OB/GYNs who currently offer TLH at Blue Ridge HealthCare hospitals include S.R. Evans, III, MD, Thomas Pope, MD and Carroll W. Ellison, MD.

“There aren’t many gynecologists in Western North Carolina doing this kind of procedure,” Dr. Mohiuddin said. “It’s amazing that here in Burke County we have so many doctors doing TLH. Blue Ridge HealthCare is fortunate to have this many gynecologists offering such services to women in Burke and surrounding counties.”

Dr. Kirk agreed that in our surrounding area, Blue Ridge HealthCare-affiliated physicians seem to be leading the way with TLH.

Dr. Mohiuddin added that another plus for the TLH procedure is that women seem to face it with less fear.

“TLH can help a lot of women who unfortunately have to go through this kind of procedure due to different conditions,” he said. “Faster recovery and less pain equals less apprehension.”

Dr. Hall cited recent pain score tracking figures from the recovery room (ratings from 1 to 10 with 10 being most severe). “They revealed a dramatic improvement over traditional hysterectomy scores,” he said. “The average pain score was two in recovery. At discharge, the average was one.”

Dr. Kirk said most women who have the procedure leave the hospital in less than 24 hours. They are also able to get back to their normal lifestyle much faster, though still with some limitations.

“I give my patients the option to return to work within three weeks,” Dr. Kirk said. “Full recovery is still six weeks, regardless of the surgical approach. Most women can go back to work within two weeks if they are feeling up to it.”

For a free information packet about TLH, call 828-580-5810.

To search for information on a variety of health topics, please visit our web site at www.blueridgehealth.org.

tony glenn is a writer and graphic artist in Blue Ridge HealthCare’s Marketing and Public Relations Department.

Advantages of TLH vs. other hysterectomy procedures:

• Avoidance of a large abdominal wound. This results in fewer complications and decreased hospital stay. Many patients go home the same day as the surgery.
• Faster recovery and earlier return to work. Patients can usually assume light duty function in two to three weeks.
• Less blood loss. The limited amount of blood lost in the laparoscopic procedure can minimize the need of a blood transfusion.
• Reduced need for catheterization. Patients usually leave surgery without a catheter.
• Less post-operative pain. Less invasive techniques equal less discomfort.
• Less abdominal scarring.

The second largest employer in Burke County, Blue Ridge HealthCare serves a four-county area and includes Grace and Valdese hospitals, Blue Ridge Home HealthCare, Grace Heights and College Pines Health & Rehabilitation Centers, Grace Ridge Retirement Community, Phifer Wellness Center and a number of physician practices.