The World Record
Academy recently announced that it has awarded Dr. Greg J. Marchand a world
record for performing a hysterectomy through the smallest incision
ever. Awarded the World Record for “Total Hysterectomy Performed through the Smallest
Incision,” Dr. Marchand removed a uterus, ovaries and Fallopian tubes, all
through an incision the diameter of a AAA battery – with no visible scar. Dr.
Marchand’s World Record was awarded after a lengthy verification process
performed by the Academy to verify the results (see full World Record Surgery Fact Sheet below
and at:
http://www.thomas-pr.com/136/photos/WorldRecordSurgeryFactSheetAugust2018.pdf).
Dr. Marchand performed a hysterectomy through a small 11mm incision at the bottom of the belly
button using a technique called “Laparoscopic Single-Port Hysterectomy.” Dr.
Marchand, Accredited Master Surgeon,
developed this technique and led the surgical team that performed the surgery.
The procedure was a modified version of a laparoscopic hysterectomy, where the
only incision used is in the patient’s umbilicus (belly button).
Dr. Marchand said, “A very novel part of our technique is
that because of the instrumentation we use, the incision is always going to be
a reproducible 11 millimeters. It’s
a great advancement for minimally invasive surgery. When the incision shrinks
from 15mm to 11mm, there are many benefits to the patient. There will be less
postoperative pain, a quicker postoperative recovery, and a much lower chance
of the incision causing a hernia later, which is a known complication of this
type of surgery. My favorite part is that you can’t even see the incision on
the patient.”
I had a chance to interview Dr. Marchand to learn more.
Q: Besides scarring, what are the advantages of making small incisions for surgery?
A: There are a lot of advantages to smaller incisions! Obviously the cosmesis that you already mentioned is a big factor, but the biggest factor is recovery. If you have smaller incisions in the skin, and more importantly smaller incisions in the fascia, you will have less pain and less recovery from the surgery. In other words you will be sore after surgery for less time and get back into your life more quickly. The fascia is the strong inside layer of the abdominal wall, and we've found that small incisions through fascia, especially when made with a blunt tipped instruments, are easy to recover from. Big incisions that need to be sutured, like the incision to remove a baby at the time of a cesarean section, require a lot of recovery and much more pain. Also the chance of complications is higher with larger incisions. This can be minor complications like an infection or poor scarring, but could also be serious like a hernia in the area of the incision or the wound opening up later!
Q: How are you able to perform surgery through such a tiny cut?
A: We are able to perform the surgery through the tiny holes with the use of special techniques and special equipment. The telescope we use (Called a laparoscope) is only 5mm in diameter. We also use small instruments from 3-6mm in diameter each. Some are called "graspers" that grab tissue like tweezers, others are just a small version of scissors. Some other special instruments have built in electrical functions so they can cauterize tissues. We use special techniques to keep the instruments from clanging into each other while operating.
Q: Why did you decide to focus on minimally invasive surgery?
A: In medical school I had the benefit of some very good surgeons who were already practicing minimally invasive surgery, so I was exposed to it early on. I love the ability to help patients with surgery without subjecting them to long recoveries and weeks of pain. Most of my patients go home the same day as their surgery.
Q: How can patients find doctors that use minimally invasive techniques?
A: Although many gynecologists perform minimally invasive surgery, not all have the same level of skill, so it is very important to ask if your surgery can be performed using minimally invasive surgery. One really great organizations that promotes minimally invasive surgery is the Surgical Review Corporation in Raleigh, North Carolina (SurgicalReview.Org). They maintain a list of accredited surgeons on their website that patients can find a surgeon in their area. Of course I would recommend flying out to see me in the beautiful Phoenix/Scottsdale area if possible, and that way you can combine your surgery with a little vacation! For more information on traveling to the Phoenix/Scottsdale area for surgery you can seehttp://gregmarchandmd.com/travel-to-az-for-surgery/ or call 1-855-GYN-SURG
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