Surgical Misadventures

da Vinci Robotic Surgery

The da Vinci surgical robot helps doctors perform complex, minimally invasive surgeries like hysterectomies and prostate operations. But some patients suffer serious complications that require additional procedures, some of which can be fatal.

Developed and marketed by Intuitive Surgical, the da Vinci Surgical System gained approval by the U.S. Food and Drug Administration (FDA) in 2000. California-based manufacturer Intuitive created the multi-armed robot to assist surgeons with more precise, minimally invasive surgery through small incisions that don’t require doctors to open the abdomen.


One of my readers commented asking if I’d ever heard about “Unplug the Robot”?  I replied I hadn’t.  She wrote about how the da Vinci robot she had for her hysterectomy ruined her life and other women’s lives as well.

Some of these stories are terribly tragic.

Flowers dark sky

The consequence is that little is known of the real disadvantages of the equipment [the da Vinci robot], and the injuries and deaths it may cause, even as robotic surgery is widely marketed to consumers.  ~ Dr. Diana Zuckerman.

from New Concerns on Robotic Surgeries (2013)

Personally, I haven’t heard a single terrible story of any patient I have known or treated regarding the da Vinci method which is not to say there aren’t tragedies happening left and right of which I’m not aware of.  The da Vinci robot can be used for many other surgeries and not simply hysterectomy.  While I don’t work directly with da Vinci or its company Intuitive Surgical, my blog is not about promoting the use of da Vinci itself, but rather to chronicle my experience with hysterectomy … I would have created this blog regardless of the method (and outcome) I had.

In the beginning, I was planning on having my hysterectomy the laparoscopically assisted vaginal method (no robot involved) believing there was less scarring and was easier for the surgeon.  My case was actually booked that way for a few days until I had an in-depth discussion with my GYN surgeon while also reading quite a bit about the da Vinci method.

The da Vinci is not, strictly speaking, a robot. It is a surgical tool and interface for that tool. Robots perform a pre-programmed sequence of steps that may or may not be conditional on input (think the IRobot vacuum). The surgery performed with it is only as good as the surgeon. A poor surgeon or poorly trained surgeon will not use it optimally. ~ random commenter

More here: Mishaps & deaths Caused by sSurgical Robots Going Underreported to FDA (2013)

I had a lot of trust in my surgeon … and still do.  He’s been a physician for a very long time … in fact, he graduated high school the year I was born!  He has received many accolades on his performance and patient satisfaction throughout his years of practice.  I can tell by many things about his personality that his “job” of being an Ob/Gyn was a career and calling.  Luckily, my hysterectomy performed with the da Vinci robot laparoscopically assisted went off without a hitch.

FEAR Eleanor Roosevelt quote

Sometimes when surgeries don’t go as expected there are numerous reasons for these problems like:

  • The baseline of the patient’s basic health.  If you start out with a patient who has lung or heart problems there are simply greater risks involved in healing and effects of anesthesia and recovery from surgery.
  • Age can also play a role in a patient’s recovery — in general, the young and the elderly are at higher risks because the young have smaller bodies (typically) and aren’t fully developed like an adult, and the elderly can often have less lung reserve capacity, decreased ability to heal as quickly, less physical mobility and flexibility to name just a few challenges with this group.
  • The patient’s psychological baseline and readiness for surgery is a huge component in successful recovery.  Sometimes surgeries are emergencies and the patient cannot take the time to adequately prepare emotionally for surgery.  Some people struggle with anxiety and depression among other mental health and chemical imbalance disorders that can sometimes place them at a disadvantage with healthy coping mechanisms in terms of recovery.
  • The experience of the surgeon really is one of the key components to successful surgeries, but not all patients are the exact same in anatomy and health status, so that the surgeon has to draw on experience making the best decision at the time when a surgery goes awry.  There is a lot to be said for training and the number of that type of surgery he/she has performed.
  • Patients bodies are many times similar in general, but can often be unique.  If a patient is a person of size (POS), there are going to be much greater challenges to performing many surgeries and the anesthesia risk increases as well (think short neck and/or sleep apnea).  When a POS has extra body tissue it is not often muscle, but rather fat and adipose tissue simply doesn’t heal as well as non-fatty tissue because it lacks the vasculature to deliver nutrients via the blood to assist in the healing process.  Special surgical (and scanning) tables are often required for patients weighing over 350 lbs. (~ 160 kG).  It is more difficult to physically reach into a patient that has a greater visceral depth while specialized equipment is needed to keep the area open for the surgeon to have an adequate working field.
  • Another factor in having a successful outcome for a surgery is the team in the operating room, the recovery room and even the area where the patient will recuperate — AKA the nursing floor.  The more experienced the team, the more outcomes they have seen and worked with.  A newer nurse may know something is amiss after surgery, but an experienced nurse may know what that problem is more quickly related to having more time-in-grade experience.  Whether the nurse is newly graduated or has dozens of years of experience is immaterial if he/she lacks care.  Care and attention should be the primary components of caring for all patients.
  • Malfunctioning or lack of the proper surgical equipment can lead to disastrous results.  However, in my experience, hospitals in the U.S. go through rigorous preparations to ensure their operating rooms are up-to-date with proper equipment working and available prior to the surgery.  There are many regulatory agencies that mandate this such as OSHA and JCAHO.  Surgeons will leave hospitals and work elsewhere if the equipment they want and need is either not available or not functioning to their standards.

I cannot speak to the individual cases of da Vinci Hysterectomies gone awry because there can be several and differing reasons why these operations ended up as either surgical misadventures and/or maladies for the female patients involved.  One has to be careful when making assumptions that a particular surgery is “all good” or “all bad”.  The cliched saying is that medicine is both an art and a science.


I recommend anyone contemplating a non-emergent surgery to get a second (or third) opinion and do as much possible research on the surgeon including his/her experience with any robotic equipment, the hospital where the surgery will be performed along with the technique of surgery recommended — and this advice is not merely for the laparoscopically assisted da Vinci hysterectomy, but ALL other major surgeries as well!  Another recommendation I’d like to make is to explore ALL other options — especially non-surgical weighing the pros and cons, risks and advantages of each.  Surgery doesn’t always have to be the answer.

There are horror stories about robotic surgeries gone awry found in the pages of thousands of lawsuits. But experts interviewed by Healthline lay the blame for these negative outcomes at the surgeons’ feet, not at the robot’s. Whenever a new technique enters the operating room, some doctors make mistakes with it. They are, after all, only human.

‘When [laparoscopic surgery] was introduced, there was a spike in patient complications. That was because, in general, the surgical field was getting trained; there were errors, there were mistakes. Now fast-forward, this is just kind of par for course when it comes to introducing a disruptor. You’re going to run into these issues,’ said the ECRI Institute’s Schabowsky.

The key is for patients to minimize their chances of being one of the mistakes by ensuring their surgeons have ample experience with any device they plan to use in the OR. That information can be hard to get, the experts agreed — only cardiac surgeons currently make such records available to the public.

But consumers aren’t doing their part, either. ~ Cameron Scott 

from HealthLine (Feb 2015)

There are women out there who have researched their surgery, were in good health, trusted their surgeon and still had complications from their hysterectomy … my heart goes out to all of these women!  It’s possible I could have been one of them and this blog would be written with a completely different perspective.  Fortunately most elective surgeries do turn out well with most people being greatly satisfied they chose to have the surgery to include the robotic method.  It’s an extremely unfortunate circumstance of life all surgeries cannot go 100% well without any problems … living life and having surgeries involve risk.  Merely being alive is risky … but it beats the alternative.

Nothing is perfect etc

P.S.  You can read more about da Vinci surgery on my previous post:


2015 in review

Here’s MY year in review … just in case you’re interested. 🙂

Here’s an excerpt:

Madison Square Garden can seat 20,000 people for a concert. This blog was viewed about 68,000 times in 2015. If it were a concert at Madison Square Garden, it would take about 3 sold-out performances for that many people to see it.

Click here to see the complete report.

My BORING one year post-op follow-up and … HORMONES!

Yeah, I know, what a lackluster title … blah, blah, blah and hormones.  I’ve just kept all the men away like kryptonite!

hot perimenopausal women

While the eye-catching post of: Uterus Regrows with Baffling Different-sized Twinling Gestation and Migratory Brain Cancer Cells Found on Dehiscing Vaginal Cuff! might grab your attention (or probably confuse you or make you vomit) I’d soon be dead from shock and impending complications if it were true.

 I’ll stick to alive, healthy and boring.

bored catMy one year follow-up post hysterectomy went well.  To recap, I had the TOTAL hysterectomy — meaning the whole uterus and cervix were removed.  (Total has nothing to do with the ovaries and tubes).  I kept my ovaries and tubes.  The surgical method I had was the da Vinci laparoscopy — the robot.  


This is the first time I’ve seen my Gyn since my 6-8 week post-op follow-up last year. He has been out of commission due to recurrent head and neck cancer.  At this recent visit, I received a breast and pelvic exam.  I didn’t need a pap smear — I don’t have a cervix anymore.

According to

If you’re an older woman or you’ve had a hysterectomy, you may think you don’t need routine Pap smears. But, if you have a cervix, [my emphasis] it’s crucial to be screened. Even if your uterus or ovaries were removed, you still need to be checked. While Pap smears don’t detect ovarian, vulvar, uterine or vaginal cancer, pelvic exams [my emphasis] –which are usually done at the same time as your Pap smear—will uncover any suspicious growths, discharge or swelling. Both the Pap smear and pelvic exam underscore the importance of making them an essential part of your preventive health routine.

I had two questions — both hormone-related for my Gyn:


Does hormone replacement therapy (HRT) contribute to or cause dementia?  I thought there was a protective element from developing Alzheimer’s by taking HRT (estrogen & progesterone), but now I seem to be hearing that hormones can cause or worsen dementia.

HIS ANSWER: Hormones don’t necessarily worsen or cause dementia necessarily , but the Women’s Health Initiative (WHI) found that women who started taking hormones after menopause were more likely to develop heart disease and/or dementia-like changes, along with women over 60 years of age.

menopause night sweatsQuestionTwo

Can I continue on the course of Lo loestrin that I’m taking?  Should I change to a progesterone-only pill?  I need the progesterone, otherwise I end up with hormonal headaches.  Remember, I tried the EstroGel (estrogen only) after my hysterectomy and my headaches came back.  I have read that progesterone increases deep sleep — stages three and four which is likely to stave off hot flashes and night sweats (vasomotor symptoms).

HIS ANSWER: Yes, I’d recommend continuing the Lo loestrin, but when you reach 50 we’ll have to talk about changing your hormones at that time to prevent or decrease any cardiovascular associated-risks.  You still have a few years to go!


* This is not an endorsement for Lo Loestrin Fe.

* This is not an endorsement for Lo Loestrin Fe.

According to Dr. Robert L. Barbieri, MD, a low estrogen oral contraceptive may be useful for the perimenopausal woman…. yes, you read that correctly — contraceptives are hormone combinations that aren’t used only for the sole purpose of birth control; they are also used for HRT.

During the perimenopause, many women have cycles characterized by markedly abnormal hormone levels. For example, some cycles in perimenopausal women are characterized by excessively high estradiol secretion and very low progesterone secretion. Other cycles are characterized by low estradiol secretion for an extended length of time. These abnormal patterns of hormone secretion contribute to menstrual cycle length irregularity, menorrhagia, and vasomotor symptoms.

Treatment with a progestin-dominant OC [oral contraceptive] is often a first-line option for these women. Because Lo Loestrin Fe contains an ultra-low dose of ethinyl estradiol, it might be a good option for perimenopausal women who suffer a menstrual disorder. The lowest effective dose of a drug is, we know, typically a good choice because it’s likely to minimize the risk of side effects.

Full article HERE!


epa02393687 A commercial handout image released by Business Wire on 14 October 2010 shows Samsung's 'Everyone Is Art' is a re-creation of Botticelli's 'Birth Of Venus' and includes the faces of 1,096 people in Europe who have been affected by breast cance

A commercial handout image released by Business Wire Oct 2010 showing Samsung’s ‘Everyone Is Art’ — a re-creation of Botticelli’s ‘Birth Of Venus’ including the faces of 1,096 people in Europe who have been affected by breast cancer.

Via WHI:

Q. What advice can you give to women about taking estrogen-alone and estrogen-plus-progestin therapy?

A. We recommend that women follow the FDA advice on hormone (estrogen-alone or estrogen-plus-progestin) therapy. It states that hormone therapy should not be taken to prevent heart disease. These products are approved therapies for relief from moderate to severe hot flashes and symptoms of vulvar and vaginal atrophy. Although hormone therapy is effective for the prevention of postmenopausal osteoporosis, it should only be considered for women at significant risk of osteoporosis who cannot take non-estrogen medications. The FDA recommends that hormone therapy be used at the lowest doses for the shortest duration needed to achieve treatment goals. [my emphasis] Postmenopausal women who use or are considering using hormone therapy should discuss the possible benefits and risks to them with their physicians.

from WHI


All in all, all is all well all… cat FISH glasses

  • orgasms work just fine
  • my urine stream isn’t as strong or fast as pre-hysterectomy
  • no more dysmenorrhea!  THE REASON I HAD THE SURGERY TO BEGIN WITH!
  • still have some hot flashes
  • one bumpy scar above my navel
  • no more pap smears
  • and … some other stuff my perimenopausal brain prevents me from remembering

cat menopause


Happy hysterversary to me, happy hysterversary to me …

Yep, one year has passed since my uterus was removed and sent to pathology never to be seen again.  What a weird thing to remember and celebrate — a hysterectomy anniversary!

My husband and I are going to celebrate by eating BBQ tomorrow — Texas style! (as if there is any other style!)

BBQ - Texas Style

What it is: Highly influenced by Czech and German immigrants, Central Texas has a huge number of meat markets that serve heaping portions of brisket and ribs smoked over pecan or oak wood. Meat is king here, and sauce and sides are treated as secondary elements.

Taking out my meat only to celebrate with eating meat — oh, the true vegetarians and vegans are cringing now.

So, the other day I’m on the phone asking the person if they are on any special diet.  She tells me that she’s a vegetarian, but eats fish, chicken, turkey, all seafood, eggs and cheese.  I want to exclaim you’re not a vegetarian — you’re someone who doesn’t eat red meat!  But my grown-up pants were on so I restrained myself.

This also reminds me of the “vegetarians” who eat cheese, milk, pasta — especially spaghetti, bread, eggs, corn, rice, tofu, mashed potatoes, cake, ice-cream, candy, chocolate … notice there are no real vegetables here.  I want to tell them that they are not real vegetarians but simply people who avoid meat.  The preceding description of “vegetarians” finally explained to my brain how vegetarians can get to be plus-size  … because silly me, once upon a time, I thought vegetarians actually ate vegetables.

Back to the meat of this post … one of the best things about BBQ meat is the smoke ring!

Besides celebrating the success of my operation and the days of pain left in the dust I’ve also put some thought to what I would have done differently in regard to planning my surgery and the recovery process.

I’m very satisfied about the method I chose: da Vinci laparoscopic total hysterectomy leaving my tubes and ovaries intact.  I have no regrets about any of this.  Although, the da Vinci is more expensive with some health insurance plans disallowing coverage for this method, I believe this was the best method for me.  My surgeon was able to have an excellent visualization inside my pelvic and abdominal area that the vaginal hysterectomy would not have allowed.  Because the cause of my dysmenorrhea, my pain, has remained a mystery, the method of da Vinci gave him one last chance to look around.  I knew that no one would ever be going back in there, so this was my last shot at possibly discovering a cause for my pain.

There is actually nothing that I would do differently in regard to my recovery process.  I can only wish that I had read the free HysterSisters booklet before my surgery — it was still quite helpful afterwards though.

The hysterectomy method is as individual as the woman having the hysterectomy and the reason she’s having it performed.

… and tomorrow there’s BBQ! 🙂

That vaginal cuff thing …

Just in case you missed this one … it’s the most widely read post here! 🙂

Most popular stamp

The MOST TRENDING POST on da Vinci Total Hysterectomy

da Vinci Total Hysterectomy

OK, if you’ve been following me on this surgery journey blog then obviously you know I’ve already had a hysterectomy … just to refresh … I had a total hysterectomy — meaning the entire uterus (this includes the cervix) was removed (total does not mean ovaries or fallopian tubes). It was performed via the really cool method of da Vinci (robot) assisted laparoscopy.  And so you also know the uterus avec* cervix (sounds like a tasty French dish, no?) came out through my vagina.

*  The word ‘avec’ is a preposition. Its meaning is with.

I may have never birthed a baby but I can now say I’ve birthed a uterus. I kept my ovaries and fallopian tubes — no family history of cancer and I still wanted the hormone function of my ever-so aging, decrepit ovaries. I have a question* pending about keeping my fallopian tubes though … Should I…

View original post 1,510 more words

What is Robotic Surgery and why have it?

Thanks for detailing the surgery Dr. McBride!

I chose the da Vinci surgery precisely due to what you’ve said — the surgeon is able to have enhanced visualization and also fine control with the robotic instrument. I hinged on LAVH but after some research opted for the da Vinci. My recovery time was quick. The hospital stay was overnight and I’d definitely recommend the da Vinci (robotic) method to any woman who is a good candidate with a gynecologist who had adequate training and experience performing this method of hysterectomy.


da vinci hyst

Womans Health Group

Since the early 90’s, major surgeries and especially gynecologic procedures, have transitioned from laparotomy  (open abdomen surgery) to laparoscopy (long thin instruments are passed into the belly through small incisions and the procedure is visualized on a TV monitor). 

There has been a major shift in moving all procedures to this minimally invasive approach. Laparoscopy is technically more challenging for the surgeon and requires advanced training and experience. The instruments are long and rigid and in some cases could compromise the operation being performed. This is precisely where robot assisted laparoscopic procedures are gaining favor. 

Fortunately, a less invasive option, like the da Vinci Robot platform, is available. For complex hysterectomies and other gynecologic procedures, robot assisted surgery may be the most effective, least invasive treatment option. Through tiny dime-size incisions surgeons using the daVinci System can operate with greater precision and control, minimizing the pain and risk associated with…

View original post 271 more words

Dr. Jen Gunter’s thoughts on VAGINAL hysterectomy

Just some food for thought here … still can’t say I have any regrets in having had a da Vinci Total Hysterectomy.  I considered the vaginal hysterectomy but after some research came to the conclusion the healing time seemed quicker with the da Vinci.

BUT it looks like insurance companies may be clamping down on cost containment for hysterectomy.  Guess THE da VINCI GANG better get to lobbying … hard!