UAE: No pain, scars with new hysterectomy technique

In a first for the Abu Dhabi Health Services Company (SEHA), doctors at Tawam Hospital have successfully performed a total hysterectomy on a 66-year-old breast cancer patient, using a novel technique: vaginal natural orifice transluminal endoscopic surgery (V-NOTES).

Hysterectomy is the surgical removal of the uterus, ovaries, and fallopian tubes. V-NOTES, a combination of two existing techniques - the vaginal hysterectomy and laparoscopic hysterectomy, is a minimally invasive surgical technique that uses the body's natural orifices, such as the vagina.

The prime benefits of V-NOTES include no visible scarring, less post-operative pain, requiring fewer painkillers, fewer post-operative infections, and a shorter hospital stay compared to traditional laparoscopic hysterectomy.

Dr Saad Aswad, consultant obstetrician and gynaecologist, gynaecological oncologist, at Tawam Hospital, SEHA, said: "The patient is a known case of breast cancer and has been on tamoxifen (a drug) for seven years; she presented with bleeding and pain. Our investigations indicated the need for a hysterectomy with the removal of the ovary and fallopian tube. We decided to use the V-NOTES surgical technique to ensure patient comfort in terms of scarring, pain, and recovery time."

Dr Aswad said the surgery was successful, and the patient was discharged in less than 24 hours.

"It is with great pride that I can say that our team is adept at performing a procedure that is normally done abroad. Tawam Hospital has performed around 145 hysterectomies in 2021. We are constantly pushing ourselves to train our medical staff in the latest techniques while maintaining the highest international standards. This will contribute to providing our patients with world-class quality services and further reinforcing the emirate's position on the global map as a leading medical tourism destination."

V-NOTES is a new technique that requires special training and practice to perform. The technique overcomes the limitations of traditional laparoscopic surgery. It enhances visualisation and access compared to traditional vaginal surgery, allowing doctors to completely explore the peritoneal cavity that houses the stomach, spleen, liver, and other organs while maintaining constant visual control of the adjacent body structures.

It makes way for easier identification of the uterus, enhances the ability to address pelvic floor support, and facilitates the removal of the ovaries, fallopian tubes, and ligaments that hold the reproductive organs in place and large uteri.

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The novel surgery also offers peace of mind to the patient as it has no visible scarring and significantly shortens the time to recovery. The patient thanked the doctors for world-class treatment and care.

"My condition has markedly improved. I am thankful that I have no visible scarring or debilitating pain. The best part was that I could go back home within 24 of the surgery. This was such a huge plus point of the whole procedure. Everything went smoothly, and I am doing much better now."

• Abu Dhabi