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Decisions, Decisions: SILS Or A Standard Hysterectomy?



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When a woman is told by her gynecologist that she needs a hysterectomy, it is certainly a life-changing moment, even if the woman has undergone menopause. There is something otherworldly and scary about needing a procedure that removes parts of one’s body, especially if involves the uterus, vagina, fallopian tubes, or cervix. At that point, the woman is faced with making a decision on what type of hysterectomy surgery she will choose as there a number of options for her: Traditional hysterectomy procedures or the new Single Incision Laparoscopic (SILS) method.

Reasons for a Hysterectomy

Hysterectomies are required if other methods of healing and cure have been unsuccessful. Here are the most prominent reasons why a woman would need a hysterectomy. These will help her in deciding whether she should opt for a traditional hysterectomy or go with the SILS method. As well, her doctor will help guide her to the right surgical option, and much of his or her counsel will depend on the grade of health she is in, whether she or not her body mass index is over 40% and other factors. The SILS method is beneficial for all of the following, while various forms of traditional hysterectomies may be useful for one or more.

If the woman has any of the following, some form of a hysterectomy will probably be required once all other options have been exhausted or deemed ineffective.

  • Cancer – This is the most obvious and often includes a radical procedure in which not only the entire uterus is removed, but also but possibly the fallopian tubes, ovaries, and cervix as well.
  • Chronic Pelvic Pain – If all other methods of reducing or stopping pain in the uterus have been tried, the uterus may need to be removed.
  • Fibroids – Fibroids are benign tumors growing inside the woman’s uterus causing pain and discomfort. Some shrink after menopause and not all require a hysterectomy.
  • Endometriosis – when a woman experiences severe pain during their periods, during or after sex, or even between periods, endometriosis may be evident. Occasionally medication can help, or even minor surgery, but if not, then a hysterectomy should be scheduled.
  • Prolapse of the Uterus – This occurs after giving birth or in women who are obese, and is when the womb slips into the vagina. Urinary, pelvic pain and problems, and difficult bowel movements may be the result.
  • Adenomyosis – This occurs when the lining of the uterus starts growing on local organs causing severe pain. A hysterectomy is the last resort to deal with this problem.

Comparing Traditional Hysterectomies to the New SILS Method

Medical technology and procedures continue advancing that helps gynecologists determine the best hysterectomy operation their unique patients will require. Again, there are a variety of reasons for choosing any of these, and the gynecologist will help the patient make the best decision for the welfare of their short- and long-term health. Of course, the gynecologist will consider non-invasive options at first, if it makes sense, and only recommend a hysterectomy if either they do not alleviate the problem, or if it is the only reasonable option.

Traditional hysterectomy surgeries usually leave behind scars as long as 7”, multiple scars because of multiple incisions that need to be made, overnight hospital stays as long as three days, trauma to the body as the surgeon needs to cut through lots of skin, muscles, and connective tissue to get the uterus, fallopian tubes, cervix, and ovaries.

The SILS method utilizes a single incision in the woman’s belly button no larger than a nickel and enters there into the body reducing the need to cut through so much muscle, skin, and connective tissue. As well, this procedure, because of the entrance location and way it is done, may leave behind no visible scars.

This is very important and one of the leading questions women ask when considering what kind of hysterectomy surgery they will choose. Typically, if a woman is losing certain parts of her body then she will want to at least not have long and multiple scars to go along with it. Moreover, because this method requires only a single incision, it does less damage to the body, minimizing the trauma and pain that follows surgery, while, as a result, reduces the time it takes to heal and recover.

Traditional Hysterectomy Surgeries

  • Abdominal Hysterectomy – A 5-7” incision is made right above the pubic area in the lower abdomen region. The court may be vertical or horizontal across the body. A scar is left behind as a reminder of the hysterectomy operation.
  • Laparoscopic Surgery – Three incisions are made in the lower abdomen areas – one central and two off to the side. The surgeon enters through the center cut with a small wand that has a camera and light attached to it. The surgeon watches on a monitor allowing the laparoscope to guide his or her hands as the hysterectomy is performed. This leaves behind three scars and is more traumatic than the SILS method.
  • Laparoscopic-assisted  – This is where the surgeon removes the womb through the vagina using the same lighted technology as seen above.
  • Vaginal Hysterectomy – It is the same as the assisted but without the use of the laparoscope. A small incision is made in the vagina to remove the uterus and then is stitched up.

The SILS Procedure

Many women are opting for the SILS method because it reduces trauma in the body, and, therefore, mandates less recovery time and healing, much less pain following the procedure. As well, the incision, roughly only 20mm, is made in the belly button where it obscures any scare that may be left behind, which happens occasionally as much of the time no scar is evident.

A SILS port is a soft, flexible instrument that is then inserted through this incision that has three different openings that allow for three separate surgical pieces to do the work of removing the uterus. Recovery time is similar to the laparoscopic hysterectomy of 2 weeks, but, again, there should be no visible scars, less pain, and a quicker procedure.


A woman in need of a hysterectomy will be guided by her gynecologist in choosing the right procedure, but many now are leading women to choose the SILS method for the reasons listed above. While the technology is relatively new, it is being used by many of the top hysterectomy surgeons and hospitals in the United States, including the Piedmont Medical Center (PMC) in Rock Hill, SC. PMC SILS Surgery is commonplace, and the feedback from their patients is outstanding.