Inpatient Procedures

Services ⋅ Hospital Procedures

Inpatient procedures are ones that require one to two days of inpatient hospital recovery.

Hysterectomies can be performed four ways:

Robotic Assisted Hysterecomy (Preferred method)

General Overview:

  • This procedure involves the use of a robot to assist in the surgical removal of the uterus.

How It Works:

  • Like laparoscopic assisted hysterectomy, the robotic assisted hysterectomy utilizes the same approach through small abdominal incisions, however is currently the most preferred method for performing a hysterectomy.
  • The advantages include faster recovery time, less post operative pain and increased ease for surgeon.
  • The surgeon uses the robotic arms to perform surgery while virtually controlling them at a console. The surgeon looks through a 3D microscope while using hand pieces at the console to virtually move the arms of the robot. This gives the surgeon the advantage of seeing very microscopic areas of the anatomy as if they were up close, and operating with impecible precision.
  • The instruments used during this procedure have maximum flexibility in movements superceeding that of the human hand. They also have a tremor reducing quality that will ensure fine movements and end any inadvertant injury to surrounding organs.
  • Because the robotic arms are placed at certain points on the patient, and move in very specific manners, there has been documented improvement of post operative pain.

Patient Requirements:

  • Defining Criterion: Patient has scar tissue, previous surgery, uterine prolapse or enlarged uterus.
  • Abnormal bleeding, which is unresponsive to medical management
  • Fibroid tumors that cannot be treated medically
  • Endometriosis
  • Patients who have completed childbearing

Recovery:

  • Many patients do not even require narcotics for pain following their surgery.
  • Like with laparoscopic assisted hysterectomy, there is a very fast recovery time when compared to an open procedure.
  • Patients are usually discharged from hospital the day following their surgery and can return to work in as little as two weeks!

Total Vaginal Hysterectomy (Second Most Preferred)

General Overview:

  • The procedure is a minimally invasive removal of the uterus, prompted by presence of fibroids, endometriosis, and prolapse.
  • This procedure is considered the most minimally invasive with removal of the uterus accomplished through the vagina. As such, the procedure does not require an abdominal incision.
  • The procedure is heavily recommended by the American College of Obstetrics and Gynecology:
    • “Evidence demonstrates that, in general, vaginal hysterectomy is associated with better outcomes and fewer complications than laparoscopic or abdominal hysterectomy...Vaginal hysterectomy is the approach of choice whenever feasible, based on its well-documented advantages and lower complication rates.”

How It Works:

  • The procedure is the removal of the uterus through the vagina. Instead of the traditional suture ligation, Dr. Bhatia uses the Ligasure Method.
  • The Ligasure vessel sealing system is a unique energy-based ligation method. Complete homeostasis is achieved by reforming the collagen and elastin in vessel walls to form an autologous seal.
  • The benefits of the Ligasure method include the following:
    • Significant reductions in operative blood loss
    • Significant reductions in transfusion requirements
    • Significant reductions in operative and anesthesia time
    • Significant reductions in length of hospital stay
    • Significant reductions in postoperative pain
    • Minimal thermal spread

Patient Requirements:

  • Abnormal bleeding, which is unresponsive to medical management
  • Fibroid tumors that cannot be treated medically
  • Endometriosis
  • Patients who have completed childbearing

Recovery:

  • Dr. Bhatia does prescribe mild pain relievers on a case-to-case basis.
  • Most patients resume normal work activities in two to four weeks

More Information:


Laparoscopic Assisted Hysterectomy (Third Most Preferred)

General Overview:

  • This procedure involves the use of laparoscopic instruments to assist in the surgical removal of the uterus through the vagina or in the presence of scar tissue.

How It Works:

  • The procedure requires two to three one inch incisions below the belly button and at the lower part of the abdomen on either side.
  • The core of the procedure still involves removal of the uterus through the vagina (the additional component is to assist in this removal)
  • Again, the Ligasure method is preferred.
  • The benefits of the Ligasure method include the following:
    • Significant reductions in operative blood loss
    • Significant reductions in transfusion requirements
    • Significant reductions in operative and anesthesia time
    • Significant reductions in length of hospital stay
    • Significant reductions in postoperative pain
    • Minimal thermal spread

Patient Requirements:

  • Defining Criterion: Patient has scar tissue, minimal prolapse, or slightly enlarged uterus.
  • Abnormal bleeding, which is unresponsive to medical management
  • Fibroid tumors that cannot be treated medically
  • Endometriosis
  • Patients who have completed childbearing.

Recovery:

  • Dr. Bhatia does prescribe mild pain relievers on a case-to-case basis.
  • Most patients resume normal work activities in two to four weeks.

More Information:


Total Abdominal Hysterectomy (Least Preferred)

General Overview:

  • This procedure involves removal of the uterus through an abdominal incision.

How It Works:

  • The procedure is the removal of the uterus through an approximate 4 inch bikini cut (minimize visibility of incision)
  • Many women are turning to new, advanced minimally invasive treatment options because they:
  • Again, the Ligasure method is preferred.
  • The benefits of the Ligasure method include the following:
    • Significant reductions in operative blood loss
    • Significant reductions in transfusion requirements
    • Significant reductions in operative and anesthesia time
    • Significant reductions in length of hospital stay
    • Significant reductions in postoperative pain4
    • Minimal thermal spread

Patient Requirements:

  • Defining Criterion: Uterus is too large to remove vaginally
  • Abnormal bleeding, which is unresponsive to medical management
  • Fibroid tumors that cannot be treated medically
  • Endometriosis
  • Patients who have completed childbearing.

Recovery:

  • Dr. Bhatia does prescribe mild pain relievers on a case-to-case basis.
  • Most patients resume normal work activities in two to six weeks.

More Information:


Myomectomy

General Overview:

  • This procedure involves the removal of a fibroid tumor without a hysterectomy and is intended for patients that desire uterine preservation.
  • The procedure can be performed hysteroscopicaly, laprascopically, or with an abdominal incision. Dr. Bhatia will assess the size and location of the fibroid tumor before discussing the method and course of the procedure.

How It Works:

  • Removal of the fibroid(s) from the uterine muscle.

Patient Requirements:

  • Patients with symptomatic fibroids
  • Patients with pelvic pressure, pain, heavy vaginal bleeding, or infertility resulting from the fibroid.
  • Occasional reduced satisfaction during intercourse

Recovery:

  • Dr. Bhatia does prescribe mild pain relievers on a case-to-case basis.
  • Most patients resume normal work activities in two to four weeks.

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Locations

Metropolitan Methodist
1303 McCullough Ave Suite 237, San Antonio, TX 78212
Office: (210) 222-2694|Fax: (210) 222-2565
Email: info@neerabhatiaobgyn.com
Hours:
MON-THUR: 8:30 AM - 5 PM
FRI: 8:30 AM - 12:30 PM
Methodist Stone Oak Hospital
1139 E Sonterra Blvd Suite 260, San Antonio, TX 78258
Office: (210) 222-2694|Fax: (210) 222-2565
Email: info@neerabhatiaobgyn.com
Hours:
MON: 9 AM - 1 PM  |  WED: 1 PM - 5 PM