Why have a Hysterectomy at The McIndoe Centre?


At The McIndoe Centre, Hysterectomies are undertaken using single site robotic surgery. There are many advantages to this technique over traditional surgery, including a quicker recovery period. There is less pain involved because the whole procedure is performed through a single tiny incision in the navel. This single incision enables patients to feel better right after the procedure so that they can return to normal activities and work more quickly. 

The robotic technique involves making a single incision in the umbilicus. There, a specially designed gel port is placed through in addition to the camera. Two operating channels and an assistants channel are all placed through this small port. The Da Vinci robot is used to control the camera and the operating instruments.

The McIndoe Centre offers pioneering technology in robotic gynaecological surgery for benign surgery and for gynaecological oncology. Mr McIndoe was one of the first surgeons in the field and has performed a wide range of procedures using the Da Vinci robotic system.

What is a Hysterectomy?

A Hysterectomy is a surgical procedure to remove all or part of the womb.

What are the different types of Hysterectomy?

If the entire uterus including the cervix is removed, this procedure is called a total Hysterectomy. Alternatively, it may be called a simple Hysterectomy, in contrast to a radical Hysterectomy that is done for cervical cancer and also involves removing tissue around the uterus. If the cervix is retained, the procedure is then called a sub-total Hysterectomy.

What are the different ways of doing a Hysterectomy?

The womb may be removed either through the vagina, sometimes called the “suction method”, or through the abdomen with a low transverse or “bikini line” incision. More recently, a “keyhole” or laparoscopic approach has been used, and this has been further enhanced by the use of robotic assistance. The way that the Hysterectomy is performed is often dependent on why the operation is necessary.

What is the recovery like following a Hysterectomy?

Recovery following Hysterectomy depends very much on how it is performed. The slowest recovery follows an abdominal Hysterectomy while the fastest is after keyhole or robotic surgery. With these techniques, hospital stays may be as short as 24 hours, particularly with the robotic approach. Some normal activities can usually be resumed within a few days and full activities in about 3 to 4 weeks, although recovery will always vary from person to person.

Are there alternative routes for a Hysterectomy?

Alternative ways of performing hysterectomy are useful in specific clinical situations. For women with vaginal prolapse, a vaginal hysterectomy may be preferred as part of the pelvic floor repair. In cases where a very large pelvic mass is present, or in instances of ovarian cancer, an open abdominal hysterectomy may be the procedure of choice.

Frequently Asked Questions

What is a smear test?
A cervical smear test is a simple screening test to identify women who might have abnormal cell changes on the cervix. The cell changes seen on the smear test are called Dyskaryosis and the abnormalities in the skin of the cervix are called Dysplasia or CIN. Most women who have an abnormal or borderline smear test will have, at most, very low grade changes, which usually resolve without treatment. A Colposcopy review is usually recommended. Mr McIndoe is highly experienced and skilled in acquiring smear tests in the most careful manner. Results are usually available within a few days.
What is a Dyskaryosis?
Dyskaryosis is the technical term used to describe the cell changes seen on a cervical smear test under the microscope. When cells are abnormal or borderline on a smear test “Dyskaryosis” is said to be present or the cells are said to be dyskaryotic. Our skilled pathologist can grade these changes as mild, moderate and severe Dyskaryosis depending upon the degree of abnormality seen within the cells. Mild Dyskaryosis on the smear test tends to correlate with mild dysplasia or CIN 1 in the skin of the cervix, moderate Dyskaryosis with moderate Dysplasia or CIN 2 and severe Dyskaryosis with severe dysplasia or CIN 3. However the correlation is not always as consistent as that. Mr McIndoe will be on hand to explain any term you don’t understand and treatment options with you, as well as offering colposcopy clinics.
What is a Colposcopy?
Colposcopy is a careful examination of the cervix using a colposcope much like a smear test. The colposcope is a microscope that remains outside the body and magnifies the view of the cervix 10 to 20 times. The Colposcopy procedure should not hurt if done carefully, although occasionally women experience some discomfort from the speculum during the colposcopy (the same instrument used in smears). We appreciate that a lot of these tests can be daunting but Mr McIndoe is a specialist in colposcopy and has over 20 years’ experience in the administering and diagnosis of Colposcopy tests. He runs a Colposcopy Clinic 5 days a week from his Harley Street Rooms in central London.
What is CIN?
CIN is short for Cervical Intraepithelial Neoplasia and is a term used by pathologists to describe the appearance of abnormal skin on the cervix, looked at as a section of tissue in a cervical biopsy. Dyskaryosis, on the other hand, describes the appearance of individual cells on a smear test. The term Dysplasia is used interchangeably with CIN. CIN 1 or mild Dysplasia usually correlates with a smear showing mild Dyskaryosis, CIN 2 or moderate Dysplasia with moderate Dyskaryosis and CIN 3 or severe Dysplasia with severe Dyskaryosis. We understand that these terms can be confusing and worrying. Mr McIndoe will be on hand to explain any term you don’t understand and treatment options with you, as well as offering Colposcopy clinics at his rooms on Harley Street in central London.
What is Dysplasia?
Dysplasia is a term used to describe abnormal changes in sections of tissue seen in cervical biopsies. It is used interchangeably with CIN to describe mild changes called CIN 1, moderate Dysplasia also called CIN 2 and severe Dysplasia or CIN 3. The term Dysplasia describes the abnormal, (Greek “dys”), development or growth (Greek “plasia”) within the biopsy. We understand that these terms can be confusing and worrying. Mr McIndoe will be on hand to explain any term you don’t understand and treatment options with you, as well as offering colposcopy clinics at his rooms on Harley Street in central London.
LEEP is the name of a treatment technique for high grade CIN or Dysplasia. Another name for LEEP, used more commonly in the UK, is LLETZ. LEEP or LLETZ involves the removal of the small piece of the skin of the cervix containing CIN using an electric current in a wire loop. LEEP or LLETZ can usually be done in an outpatient setting with local anaesthetic or sometimes a LEEP or LLETZ treatment can be done under general anaesthetic. The procedure itself is relatively painless when performed carefully by a skilled and experienced doctor.
What is HPV?
HPV is short for Human PapillomaVirus.re. We take HPV testing seriously and all our samples hand collected from Mr McIndoe’s rooms are viewed by our specialist pathologist personally just around the corner from Harley Street.
What is HPV vaccination for?
Almost all cervical cancers contain evidence of HPV and most authorities in this field believe that HPV infection is a necessary precursor of cancer of the cervix and also CIN or dDsplasia. The HPV vaccination is used to prevent HPV infection. Two HPV vaccines have been developed, Cervarix, which protects against HPV 16 and HPV 18, the two most important HPV types in cancer of the cervix and Gardasil, which in addition protects against HPV 6 and HPV 11; the HPV that cause genital warts. These HPV vaccines are remarkably effective against the particular HPV types and cause virtually no side effects, and so are highly recommended. These treatment options are available from Mr McIndoe at his at his rooms on Harley Street in central London.
What is cervical cancer?
Cervical cancer, or cancer of the cervix develops from CIN (Dysplasia). In CIN lesions, the abnormal cells are confined to the skin of the cervix. If these cells break through into deeper tissues, a cervical cancer develops but fortunately this happens very rarely. Most CIN lesions stay confined to the skin for many years and can be easily treated with LEEP before they become a cancer. OF course we take all aspects of your care seriously, and some of the terms used to describe an abnormality can be confusing and worrying. Mr McIndoe will be on hand to explain any term you don’t understand and treatment options with you. Mr McIndoe is a gynaecological oncologist who specialises in the fast diagnosis and treatment of these conditions at his clinic in Harley Street in central London.
Is a biopsy always done at Colposcopy?
A small sample of the skin of the cervix, about the size of a grain of rice, can be removed and sent to the laboratory for analysis. This is called a biopsy. This may be done on the first visit if a high grade abnormality is present, but is not always necessary for low grade abnormalities or for follow up visits.
What is an erosion?
This is an old name for the transformation zone.This is an area surrounding the canal of the cervix, where the delicate skin lining the canal extends onto the outer part of the cervix. It looks red and so has been called an erosion although this appearance is a normal finding. A more modern name for this appearance is an Ectropion, reflecting the origin of this appearance.
What is the significance of the transformation zone?
This is the junction between the delicate columnar skin lining the internal parts of the cervix and the tougher squamous skin lining the outer part of the cervix. This area is often called the Squamo-Columnar Junction. This is a very active area of skin where the columnar epithelium is undergoing a process called mMtaplasia, and changing into squamous skin. When Metaplasia goes wrong it becomes Dysplasia.