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Lisa's Robotic Surgery

by UPMC Susquehanna

The pain increased so gradually, that Lisa DiRocco Bartholomew, 53, of Williamsport just kept adapting to it. Or so she thought. Looking back she sees that while she kept up with the big things, making beautiful cakes for friends and family and cooking delicious meals for anyone in need, she had stopped living fully. She put aside hobbies she enjoyed, was reluctant to commit to things and often had to cancel plans because she didn’t feel good.

Lisa had challenges with her monthly cycle from a young age and in her late forties, she more or less accepted cramping and heavy bleeding as a way of life. Then a few years ago, after she started exercising and losing weight, she hit a plateau, constantly felt bloated, and even began gaining weight.

Sensing that something was wrong, Lisa saw her gynecologist in January 2016. She had fibroids, which are non-cancerous uterine growths, and endometriosis, cells like the ones that line the uterus growing within her abdominal cavity. Both were likely responsible for her bleeding and pain. He also detected ovarian cysts, which are fluid filled sacs. While none of the growths were cancerous, her doctor recommended a hysterectomy to remove them. Lisa hesitated.

“I was reluctant for any type of surgery,” she says, “After delivering two children by cesarean section twenty-some years ago, the memory of the procedure, the 14-inch incision and prolonged healing time still loomed. I did not want to go through that again, and I was afraid of the unknown, of being thrown into menopause.”

The cysts grew. With pressure in her abdomen and lower back almost constantly and something “hormonally” always going on, she was down to just two or three “good” days a month where she truly felt like herself. She researched her condition and treatment options and chose Dr. Angela Huggler to perform a robot-assisted minimally invasive hysterectomy.

“I heard UPMC Susquehanna had robotic surgery, but it’s so much more than that,” says Lisa. “It is non-invasive through three tiny incisions. I totally trusted Dr. Huggler and felt like I was in good hands. She is incredibly intelligent, articulate and answered all of my questions. I was very confident in her and thought, ‘I can do this.’”

Non-invasive procedures are the preferred method for hysterectomy because there is significantly less pain, a shorter recovery time, and less disruption to the internal contents of the abdomen and the lining of the gut. The incisions, one through the belly button and two more that are less than one centimeter each, provide entry for a microscopic camera and surgical tools that are guided by the surgeon using a robotic hand. The small incisions reduce the likelihood of infection or future complications due to adhesions from internal scarring.

Lisa arrived for her outpatient procedure at 8 am and was home by 1:30 that afternoon. Although she had major surgery that day, she immediately felt better than she had for the last three years. She took over-the-counter pain medication for just a couple days and could barely find the incision points.

“I was up and cooking the next day. I had friends and family coming over, and I think they were shocked to see how well I was doing. I think they were hoping for messy hair and no make-up,” says Lisa.

According to Dr. Huggler many women in their late 40s have struggles similar to Lisa’s. They suffer in silence figuring it will all go away with menopause.

“They don’t even realize it is getting worse because it is such a gradual change, and then they come to the realization that 70 percent or more of their life is altered,” says Dr. Huggler. “Because they are the caretakers for everyone else, healthcare-wise women tend to let their own concerns take a back seat.”

Appropriate for all hysterectomies, the robot-assisted platform is ideal for complicated cases like Lisa’s because it enables the surgeon to visualize endometriosis more easily than with the naked eye or a laparoscopic procedure. This allows more thorough removal of the tissue for better results.

Recovery time is shorter, too.

“The majority of my patients don’t need as much time off as they expect. They use fewer pain medications and often call to ask if they can go back to work ahead of schedule,” says Dr. Huggler. “It’s not like the old hysterectomy where they were in the hospital for two days before surgery and four days after.”

A few weeks after robot-assisted surgery Lisa is just beginning to realize how constant pain sapped her energy and prevented her from truly enjoying what she was doing. Feeling energized she has a new lease on life and is making plans for a big vegetable garden in the spring, has her sewing machine out again for crafting, and she’s joining the East Lycoming Choral Ensemble, a commitment she never would have made when she wasn’t feeling well. While she had minor limitations for activity following her surgery, she was cleared for weightlifting at the gym again by six weeks.

“I wish I would have done this years ago when I first started having problems,” says Lisa. “I think women just figure this is something they have to live with. I want them to know you don’t have to. If you are uncomfortable and know something isn’t right, do something now.”