Minimally invasive surgeries are a group of procedures performed through small incisions rather than large ones. The results of minimally invasive surgery include potentially quicker recovery times, fewer complications, reduced hospitalization costs and less scarring.

We are no longer limited to traditional surgery through a large abdominal incision that can be 6–12 inches long, and often result in more complications and longer recovery time. Using the da Vinci® robot, the procedure can be completed with four to six dime-sized incisions and with minimal scarring.

How do I find out my benefits for surgery?

Our office will call your insurance to get an estimation of benefits for our services based on coverage. After obtaining this information, a nurse will contact you and will collect the amount owed per your insurance company. The surgery deposit can be paid with a credit card, personal check or cash. This payment is required before the date of your surgery.

Any benefits regarding anesthesia and hospital bills will be given to you by a staff member at the hospital. We do not have access to this information and, therefore, cannot provide you with a full estimation of coverage for all services rendered on the day of your surgery.

How do I schedule my pre-op labs?

Blood work must be done prior to your surgery. In order to schedule these labs, you can call 713-242-3880 and speak to a nurse to get an appointment. These labs are typically required within 1-2 weeks of surgery.

What medications must I stop before surgery?

Dr. Levin asks all patients who are on hormone replacement (estrogen, progesterone, etc) to stop these medications 1 week before surgery. Also, any aspirin-based products (i.e. Aspirin, Motrin, Advil, Ibuprofen, Aleve) must be discontinued 1 week before surgery to decrease potential post-operative bleeding.

Any other medications you may be on including blood pressure, thyroid or diabetes medications should be reviewed with the pre-op nurses in order to obtain dosing instructions based on anesthesia protocol.

When must I begin fasting for surgery?

In order to have general anesthesia you must have an empty stomach. In general, we ask patients to be fasting after midnight.

What time do I arrive at the hospital?

In general, we ask that you arrive 2 hours before your scheduled surgery start time. This will allow for you to get checked in by a nurse who will confirm medical information and prepare you for surgery. Please use the time our office gives you as the hospital nurse may not be aware of schedule changes.

How long will my hospital stay be after my surgery?

• Robotic Hysterectomy - 1 overnight stay and discharge in the morning.
• Abdominal Hysterectomy - 2-3 days depending on recovery.
• Laparoscopy - outpatient procedure
• Cold Knife Cone/LEEP/Laser - outpatient procedure.
• Bladder Repair - outpatient procedure.

What should I expect after a cold knife cone (CKC) or Loop Electrode Excision Procedure (LEEP)?

• Vaginal bleeding is expected after this procedure and can last for up to 4 weeks. Commonly the bleeding can also increase at approximately 2 weeks. Pads are to be used, not tampons, for the bleeding.
• No sex until after your 1 month post-operative check up in the office.

What should I expect after bladder surgery?

• Bladder spasms commonly occur after bladder surgery. These symptoms usually resolve within 4-6 weeks.
• Driving is permitted once you feel able to do so. It is not advised if you are still requiring narcotic pain medications due to potential impairment.
• No heavy lifting or sex for 4-6 weeks after surgery. This is to protect the integrity of the bladder repair.

Operated by board-certified surgeons, the da Vinci Surgical System is designed to provide surgeons with enhanced capabilities, including high-definition 3D vision and a magnified view. Though it is often called a robot, the da Vinci cannot act on its own. Instead, the surgery is performed with unmatched precision entirely by the surgeon. The surgeon controls the robot as it translates his or her hand movements into smaller, more precise movements of the tiny instruments inside the patient’s body. Together, the surgeon and the robot perform complex procedures through just a few tiny openings.

A number of procedures that could not be performed using traditional technologies can now be performed using the da Vinci Surgical System. The advanced feature set and extensive EndoWrist instrumentation of the da Vinci Robotic System enable surgeons to perform more procedures through 1–2 centimeter incisions.

Benefits experienced by patients may include:

• Significantly less pain.
• Less blood loss and fewer blood transfusions.
• Minimally invasive surgical option for women with large, numerous or difficult to access fibroids.
• Fewer complications and lower risk of infection
• No overnight stay now.
• Faster recovery and return to normal activities.
• Small, dime-sized incisions for minimal scarring.
• Simplifies many existing procedures.
• Quicker recovery time and return to regular activity.

• Uterine Fibroids - to remove fibroids (myomectomy) or the entire uterus (hysterectomy)
• Endometriosis - to remove endometriosis tissue to relieve pain
• Pelvic Prolapse (including uterine, bladder and rectal) - to restore support
• Heavy menstrual bleeding - to remove the uterus (hysterectomy) if indicated
• Ovarian Cysts
• Uterine, Ovarian, and Cervical Cancer – to stage and treat cancer

Robotic surgery is categorized as robot-assisted minimally invasive surgery, so any insurance that covers minimally invasive surgeries generally covers this surgery. This is also true for widely held insurance plans such Medicare. It is important to note that your coverage will depend on your plan and benefits package.

When will I be seen in the office following my hysterectomy?

Patients are seen at 1 week and 3 weeks after your surgery for a routine post-op exam. At these visits you will be instructed on what activities are allowed and what to avoid.  Some general guidelines are listed below.

When can I drive after my hysterectomy?

As long as your surgery was performed with the assistance of the da Vinci robot, you will be allowed to drive once cleared by your doctor at your 1-week post-operative appointment. You will need someone to drive you to your first post-op follow up appointment.

When can I have intercourse after my hysterectomy?

On average, patients are to avoid intercourse for a minimum of 6 weeks following surgery or until no discharge has been present for approximately one week. During the hysterectomy, the uterus, tubes, ovaries and cervix are removed through the vagina. As a result, the top of the vagina is sutured closed and takes approximately 6 weeks to heal.

When can I exercise after my robotic hysterectomy?

Light aerobic exercise is allowed 1 week after surgery. After your final post-operative visit at 3 weeks you will be released to activity as tolerated, though gradual introduction is recommended.

When can I return to work after my hysterectomy?

Most patients are allowed to return to work at 10-20 days depending on the type of job.  A work release can be provided by our office at your post-op visit.

What should I expect after my robotic hysterectomy?

Common post-operative symptoms/complaints include:

• Bloating occurs because gas is put into the abdomen during surgery to allow for optimal visualization.

• Constipation can result from intestinal irritation from the gas used in surgery as well as the post-operative pain medications taken.

• Vaginal bleeding and discharge is expected immediately after surgery and after surgery while the stitches are dissolving. This bleeding/discharge may last 6 weeks after your surgery. Notify the office if the bleeding is heavy or if it increases suddenly.

• Incisional pain is very common after surgery. The incision located by the left ribcage has been reported to be the sorest by most patients. Pain medications will be provided to alleviate the pain.

• Bladder spasms can occur after surgery because a catheter is placed in the bladder during surgery. These symptoms are more common if a bladder procedure was done in addition to the hysterectomy.

• Hot flashes/night sweats can occur if your ovaries are removed at the time of your hysterectomy. These symptoms are to be monitored during the immediate post-operative period. For the majority of patients, the symptoms improve once a few weeks out from surgery. In the event the symptoms do not subside or improve, hormone replacement options will be discussed at your final post-operative appointment.