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MetroHealth doctors perform single-incision laparoscopic hysterectomy

(08 Aug 2008)

MetroHealth doctors perform single-incision

laparoscopic hysterectomy

Posted by Angela Townsend June 30, 2008 15:44PM

Categories: Angela Townsend , Impact , Lifestyles Impact

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Dr. Gregory Kitagawa, center, and Dr. Kevin Stepp, right, perform a single-incision

laparoscopic hysterectomy through the bellybutton last week at MetroHealth Medical Center

in Cleveland. The patient, Jackie Columbo, went back to work Monday with only a single

scar that's barely visible.



Jackie Columbo is back at work as a dental assistant today, just eight days after

having a hysterectomy.

And the only sign of her surgery? Just one tiny scar at her bellybutton.

During a two-hour operation last week at MetroHealth Medical Center, surgeons

removed Columbo's uterus through a single small incision in the base of the


In fact, just 24 hours after her surgery, she was back at home in Berea.

"I'm walking a little slower than usual," said Columbo, 43, on Monday, a couple of

hours after her return to work. But she said she feels great. "So far, so good,"

she said. "Every day is so much better than I thought it would be."

The procedure is called single-port access surgery, or single-incision laparoscopic

surgery. It has grown in popularity across the country in the past year. Columbo's

surgery, done by Dr. Kevin Stepp, a gynecologist at MetroHealth who specializes

in urogynecology and reconstructive pelvic surgery, is believed to be the first of

its kind in the Midwest.

"There are a lot of people in this country who believe that there are way too

many open-incision abdominal hysterectomies performed," said Stepp, who

performs total laparoscopic surgery, using three or four incisions, in about 95

percent of his patients with noncancerous conditions.

Dr. Gregory Kitagawa, Columbo's gynecologist, assisted with the surgery.

About 70 percent of American women who have hysterectomies have the

traditional, invasive abdominal surgery, even though minimally invasive

laparoscopic surgery could be a viable option for most of them, Stepp said.

A patient typically stays two to four days in the hospital for a traditional

hysterectomy and then spends six to eight weeks recovering at home.

Laparoscopic surgery, with its three or four incisions, shaves days off the hospital

stay and often cuts the recovery time in half or more.

A vaginal hysterectomy, where the uterus and ovaries are removed through an

incision in the vagina, is another method that can cut down hospital and recovery


The single-port/single-incision surgery provides yet another option with a quick

recovery time and virtually no physical marks left behind.

Urologists and general surgeons took the lead in adopting the single-port access

technique. Doctors at the Drexel University College of Medicine in Philadelphia

used it in spring 2007 to remove a gall bladder and ovaries in two separate


Here in Cleveland, Dr. Jihad Kaouk, the director of robotic urologic surgery at the

Cleveland Clinic, in September became the first surgeon to use the technique for

a radical prostatectomy and radical urinary cystectomy. The Clinic is among the

country's leaders in the number of single-incision surgeries performed. In

February, doctors at the Clinic's Glickman Urological and Kidney Institute were

the first to perform robotic single-port surgeries.

In July 2007, Dr. Kate O'Hanlan, a gynecologic oncologist with a medical practice

in the San Francisco area, performed the country's first single-port total

laparoscopic hysterectomy.

Stepp was one of a handful of surgeons who served as instructors at a

laparoscopic hysterectomy seminar O'Hanlan gave last year in San Francisco. He

is eager to teach other area physicians how to do minimally invasive


"We've got a ways to go," he said. "Most people who go to their ob-gyns are told

they have to have an incision because their fibroids are too big, or because

there's too much scar tissue. [Most times] those statements aren't true."

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