Jo Devane of Enterprise established a milestone for Philip Dozier, M.D. of Women's Healthcare of Dothan. In January 2006, Devane became Dozier's first outpatient hysterectomy case thanks to an innovative procedure known as laparoscopic supracervical hysterectomy.

By 5:00p.m the day of her surgery, Devane was enjoying a Chinese dinner and watching a movie with her family. "I didn't even take any pain medicine," she recalled. "I didn't need it. There was no pain, just a mild discomfort."

LSH differs from a regular hysterectomy in that the uterus is completely removed by laparoscope, while the cervix remains intact. Laparoscopic entry requires minimal invasion, allowing for a much quicker recovery.

In Devane's case, her surgery was necessitated by a five-year history of ovarian cysts. She reluctantly agreed to a hysterectomy after several painful procedures to remove the cysts. "I had considerably more pain with the cyst removal than with the hysterectomy," she said. "I should have done this a long time ago."

But like many women, Devane was nervous about what was once a radical surgical procedure. "I was a bit anxious," she admits. "I remember a friend who had a hysterectomy and was out of work for five weeks. She couldn't even answer the telephone because of the pain. She had a horrible time."

Devan said Dozier assured her the surgery would be easy and that she could go home the next day. "I half-way believed him," she recalled. "I laughed. He said I would be fine in five or six days. I thought, 'He's a man, he really doesn't know!'" but Devane was in for a suprise. After breezing through the surgery, she was insistent on going home later that same day. "I told him I was starving," she chuckled. "All they would bring me was something to drink. I wanted to go home and eat!"

Dozier admits he was equally amazed. "We had never let a patient leave the same day as the surgery," he said. "Ordinarily we like to keep them overnight for observation, just as precaution. But she said she was hungry and wanted to go home," he shrugged. "I said, 'Well, let's try it."

After an evening of lounging, Devane said she was ready to ride the lawnmower the following Monday morning. "I called (Dozier's) nurse and asked if I could get on the lawn mower, and she said, "Absolutely not!" laughed Devane. "I had to remind myself of the restrictions, because I felt fine."

Susan Sinclair of Enterprise had a very similar story. Like Devane, Sinclair suffered with recurring ovarian cysts and bleeding. To further complicate her life, she and her husband Brigadier General E.J. Sinclair are preparing for his impending retirement as commanding general of Fort Rucker. The Sinclairs plan to move from Enterprise to their beach home in Panama City, Fla. "I opted for a hysterectomy for quality of life purposed," she said. But the move afforded her no opportunity for downtime. LSH offered the option she needed to move quickly back into a normal lifestyle.

"My decision for this surgery was based on the move," she said. "I wasn't nervous the morning of surgery because I had suffered so much for a year. I had the surgery that morning and left at five in the afternoon, and we drove to the beach.  I put on a roast as soon as we got there," she smiled. "The cramps and pressure I had were gone the day of surgery."

A registered nurse, Sinclair said she knew the importance of maintaining mobility immediately after surgery, so she and her husband took a walk on the beach the next morning. "I felt fine, and I still do," she said. "Just look at me! I'm just ten days after surgery, and I feel better than I have felt in a long time."

Dozier pointed out that Sinclair's case helped him realize the need to promote LSH. "A lot of people don't even know this surgery is available," he said. "The interesting thing about Susan is her husband is at Fort Rucker. She had talked to the head of the department at Lyster (Army Medical Center), and she have never even heard of this procedure."

That realization has inspired Dozier to consider providing inservice information sessions for local medical care providers. "We really didn't know what the experience was going to be like and what the outcome would be," he said. "I was kind of skeptical, but it has made a believer out of me as far as the recovery period."

Dozier pointed out a number of benefits with the procedure. "First of all, it saves money," he said. "Outpatient surgery is less expensive thatn inpatient surgery. The quicker recovery minimizes the loss of time from your job and time away from your family." More important are the physical benefits female patients enjoy with LSH in comparison with a traditional hysterectomy. Dozier said, "First there are support issues. With LSH, you don't disturb the main ligaments that support the vagina. You leave them intact, preventing vaginal vault prolapse because the pelvic diaphragm and group of muscles and ligaments are intact." Sexual function and response is another benefit with leaving the cervix. "Some believe that the cervix plays a role in sexual performance, so that is another factor of this procedure," he said. "There are also no vaginal stitches." In fact, the only stitches required are those to close the tiny holes in the skin through which the scope and other tools pass.

LSH is not appropriate for every case, however. Dozier said, "Anyone with abnormal pap smears or a history of cancer would need a complete vaginal hysterectomy." He also reminds his patients that although LSH leaves them feeling that they have had a minor procedure, they have had major surgery and must adhere to the rules of common sense. "I mean, don't go out lifting heavy objects and overdoing it," he said. "I tell patients to remind themselves to slow down. I think as a word of caution, take it easy and try things. Your body will tell you if you are doing too much.

Women's HealthCare specializes in gynecology, obstetrics, infertility, and incontinence, and provides ancillary services in bone densitometry, ultrasonography, 4-D ultrasound, and mammography. With a few exceptions, our group can offer anything here that any of the major medical centers can. In addition to standard gynecologic care and state-of-the-art procedures which my group offers, we are also affiliated with a reproductive endocrinologist from Mobile, offering in-vitro fertilization and advanced technology for infertility patients. The group also staffs a gynecologic oncologist who commutes from Columbus, Georgia twice a month.

For more information about laparoscopic supracervical hysterectomy (LSH) or Womenxs HealthCare of Dothan, P.C., call 334-793-6511, or visit on-line at www.womenshealthcareofdothan.com.