Update on Laparoscopic Hysterectomy
Hysterectomy today and home
three hours later sounds incredible, but that is exactly what one patient did after
undergoing total laparoscopic hysterectomy at the Milwaukee Institute of Minimally
Invasive Surgery. A new technique for performing this operation has been patented,
including appropriate instrumentation, called the 'Koh Technique' and 'Koh Colpotomizer
for Total Laparoscopic Hysterectomy'.
Dr. Koh has presented this
method for the last year and a half at various meetings in and out of the country and the
product had finally been approved by the FDA in 1996. The technique simplifies and makes
the performance of laparoscopic hysterectomy safer without the use of stents in the ureter
and the operative time has been cut down to 60 minutes in simple hysterectomies. Thus far
more than 50 cases have been performed and 20 percent of the patients are discharged the
same day, with 40 percent being discharged by the following day. About 10 percent are
discharged by the second day. Occasionally, the TLH for cases of severe endometriosis is
combined with laparoscopic colon resection, bladder resection or uteric treatment,
necessitating a slightly longer stay. Because of the increased efficiency of the Koh
Hysterectomy Technique, the total hospital costs have begun to come down, allowing the Minimally
Invasive Specialists, LLC (a group of surgeons from the Milwaukee Institute of
Minimally Invasive Surgery) to start the process of negotiating fixed price treatment,
(including hospital, anesthesiology, radiology, lab and professional charges) with various
self-insured groups. The satisfaction ratio from laparoscopic hysterectomy has been
extremely high, as evidenced by postoperative follow-up questionnaires conducted by
Lisa Jaeger, RN, Specialty Coordinator with the Milwaukee Institute of Minimally Invasive
Surgery. Most women can resume some activity within three or four days and return to work
between one and three weeks. One patient completed Al's Run (a Milwaukee 5K event) four
weeks after her laparoscopic hysterectomy.
