Patient Story: Hysterectomy

The last words Kay Wieland expected to hear: you have cervical cancer

When the telephone rang, Kay Wieland was up to her elbows — quite literally — in ground beef. As the manager of the meat department of a large grocery store, her days are long and hectic. When Kay answered the phone for the umpteenth time one recent afternoon, she was surprised to hear her doctor’s voice on the other end. She was utterly shocked at his news: You have cancer.

Kay’s physician recommends a specialist

Kay had the good fortune to be referred to Dr. Pamela Paley, a gynecologic oncologist who practices at Swedish and specializes in women’s reproductive cancers. Kay’s journey back to good health began the moment she entered Dr. Paley’s office. “She put me at ease right away,” recalls Kay. "She went over my records and felt very confident she could handle my case. In fact, I remember her words exactly." She said, "This is very manageable." And I very much liked the sound of that.”

An ordinary procedure performed in an extraordinary new way

Dr. Paley recommended a radical hysterectomy for her new patient. At the very sound of the word “hysterectomy,” Kay’s mind whirled with visions of foot-long incisions and a lengthy, painful recovery. With the holidays approaching — a busy time for her meat department — she was every bit as worried about being away from her job for weeks on end. But as Dr. Paley explained that she was an ideal candidate for another type of surgery, Kay knew she was in exactly the right place.

Robotic surgery — not your mother’s hysterectomy

Dr. Paley was one of the first surgeons in the Northwest to embrace a breakthrough technology in minimally invasive surgery. She operates with the assistance of a robot — officially known as the da Vinci® System — which offers enormous advantages for both the patient and the surgeon. 

“A traditional open-surgery hysterectomy,” explains Dr. Paley, “requires quite a long incision. We have replaced that with five eight-millimeter incisions — each one is about a third of an inch. This is much less traumatic for the patient, so instead of staying in the hospital for up to a week after surgery, she can typically go home in 24 hours. She usually experiences much less pain, and many patients go home with only Tylenol® or Motrin® for pain control. And there is much less blood loss, so the need for transfusions drops. 

“What’s more,” continues Dr. Paley, “for those patients who require radiation or chemotherapy after their surgery, they’re able to begin those treatments much quicker. Instead of waiting to recover from a big surgery, they can move right into those extra treatments with fewer side effects, because they have fewer side effects from the surgery itself.”

Four hands are better than two

The da Vinci System includes a patient-side cart with four interactive robotic arms — three hold surgical instruments and the fourth a tiny camera. Each of the four robotic arms is paired with one of the five tiny incisions — the fifth incision is used to introduce supplies such as sutures and needles. The surgeon controls these robotic arms while seated at a console, which provides an extremely high-definition, highly magnified, three-dimensional view of the surgical field. As Dr. Paley’s hands manipulate the controls, the system translates her motions into precise, real-time movements of the instruments inside the patient. 

“An obvious advantage of robotic surgery,” explains Dr. Paley, “is that I immediately have four hands instead of two. The flexibility is much greater. With the magnified view, I can see the entire abdominal cavity through the tiny incisions — very important for cancer surgery. I can actually see much better than with a traditional open surgery. If I need to access a tiny space under a large blood vessel to examine a lymph node, for instance, I simply move the controls and I can be right there.”

Dr. Paley operates; the robot assists

Dr. Paley had no trouble convincing Kay that this was the right choice for her. They scheduled her three-hour surgery for early one Friday morning. Kay had a single, perhaps unusual request before the surgeon began her good work: “I want to meet Mr. da Vinci!” So Kay was wheeled into the operating room and “introduced” to the robotic system before her surgery began. 

All went exactly as planned, and just after lunch on Saturday, Kay was on her way home. The following Friday, she went to dinner and a concert with her daughter. Four weeks to the day after her surgery, Kay was once again taking charge of her department at the supermarket. “If I had a desk job, I would have been back in ten days, but because I do so much heavy lifting, we thought it best to wait a little longer,” she reports. Kay wasted no time getting back into the swing of her long and action-packed days. “It was inventory time, so my first day back lasted 11 hours.”

The best possible news for Kay

If Kay had an extra bounce in her step after her surgery, she had good reason: after all the lab results came back, Dr. Paley pronounced her surgically cured, so no further treatment was necessary. “All the margins around Kay’s tumor were clear, so she is considered cured with her surgery alone. We’ll watch her very carefully in the months and years ahead, but her prognosis is excellent.”

Take it from someone who knows

What advice would Kay give to someone who finds herself in need of excellent health care? “First of all,” she admonishes, “get in for your annual exam every year. No excuses!" 

Indeed, Kay’s annual exam this past year could well have saved her life. For those who require more specialized care, she would recommend Swedish in a heartbeat. “From the very beginning, I felt so good about going to Swedish. The best hospitals attract the best doctors, and we are so fortunate to have access to state-of-the-art technology. And if you do need surgery,” continues Kay, “by all means, ask about robotic surgery. At least for a while, Mr. da Vinci could be your new best friend.”