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The Daily Citizen

Faster Recovery - Eliminating the Fear Factor

By Kyle Melinn

Preparing for a hysterectomy for whatever reason cancer, constant pain or other health problems has historically been an occasion for women to fear. Recovery from a hysterectomy used to take three to six weeks, especially for an abdominal hysterectomy, which necessitates an "incision several inches long in the belly," cutting the abdominal muscles and leading to a long recuperation period, said Dr. John Turrentine, a Dalton-based Ob-Gyn.

Development of the LAVH (Laparoscopic Assisted Vaginal Hysterectomy) enabled "a much faster recovery, about 10 days," Turrentine said, but there were still problems with pain and scarring and with other complications.

Along with Dr. Sidney Sellers, with whom Turrentine practiced until September when Sellers retired, Turrentine developed a new hysterectomy process they called MIVH, Minimally Invasive Vaginal Hysterectomy to combat the negative side of the procedure.

"I've done hundreds of these surgeries," Turrentine said. "MIVH is much less expensive, it requires less equipment and it takes about a third as long as an LAVH. There's less chance of injury, of scar buildup, less reason for concern from a cosmetic standpoint."

The process has been developed over the past four years, he said. "I've done several hundred of them," Turrentine said. "We did all of our cases together, so we developed it together."

When a hysterectomy is done through the abdomen, six layers of tissue are penetrated and different organs are affected by the instruments used. With the MIVH, two small holes are made in the affected tissue "and only two layers of tissue are affected." He said.

The recovery process is where the major benefit of the procedure is seen. While LAVH was a distinct improvement over abdominal hysterectomy, recovery from the MIVH is quicker still.

"If patients are in here at 7:30, we'll have them out by 11," Turrentine said. "Or if it's a late afternoon surgery, we'll keep them overnight. If we schedule someone for a Wednesday, she can be back to work on Monday." That was certainly the case for Mary Tallent, 39, who had a hysterectomy two weeks ago.

"My surgery was on May 27 at 7:30 a.m., and I left there at 11:25 that morning," Tallent said. "By 9:30 I was ready to go home, but he asked me to stay until after 11 just in case." The quick recovery time Turrentine promised was what sold Tallent on the surgery.

"This was the very first time I had gone into surgery, and some of the ladies at school (she works at Southeast Whitfield High) had just scared me to death," Tallent said.

"They said it was a major surgery, that I wasn't going to be able to go home, that there would be several weeks of recovery. "So I called Dr. Turrentine and told him we needed to talk. He and his staff are just so great. He took time out of his schedule to explain everything to me, going through the process step by step."

As a result of Turrentine's pep talk and explanation of the procedure, Tallent decided to go ahead with the operation. The fact that she had cysts that couldn't be addressed without surgery also helped her decision.

"The day I had surgery and came home, I swept my kitchen floors," Tallent said. "It was amazing. The next day I went shopping and the day after that I planted flowers."

This isn't to say that there isn't any pain with the minimally invasive procedure. There is, Tallent said, but it's insignificant.

"Oh, there was some pain the day after the surgery, but not much," she said. "He gave me a prescription for 20 pain pills, and I still have 16 of them.

"He said, 'You'll be back to your normal self in two weeks,' and I was back to normal within a week."

Dr. Turrentine's procedure isn't for everyone, and it isn't applicable in all situations, he said.

In some cases there are still advantages to the LAVH, Turrentine said. "If someone is concerned that they might have a recurring cancer, or upper abdominal pain, the advantage of LAVH is that you can see the upper abdomen."

But many more hysterectomies could be done using Turrentine's method.

"In 70 percent of the hysterectomies nationally, the uterus is removed abdominally," Turrentine said. "According to the American College of OB-Gyns, 70 to 80 percent of all hysterectomies should be done vaginally."

With this information prodding him, Turrentine spends a great deal of time teaching his procedure. "I go all over the place teaching it," he said, noting that last week he was in Baton Rouge, La., on Thursday night for a dinner meeting, then in Washington, D.C. this Monday and Winchester, Va., on Tuesday, teaching MIVH to other surgeons.

He is also on the clinical teaching staff of the Medical College of Georgia, teaching students on rotation when they come to Hamilton Medical Center.

"I've taught this at Tulane and Vanderbilt, in Chattanooga, in Los Angeles, all over the country," Turrentine said. "Once they come and watch it, it's so much simpler and easier than what they're doing now, both for the surgeon and for the patient. It takes much less time and there's less time spent in recovery."

Turrentine also lectures on other topics relating to his profession. It means time away from his practice, but "I love to teach," he said.

His love of teaching shows: He has also authored two books on his specialty.

The first, written in 1991, detailed surgery techniques and is soon to be released - on CD Rom - in its second edition.

More popular, however, is his book Clinical Protocols in Obstetrics and Gynecology.

Published in 2000, the book has become a bestseller and is used in medical schools all over the country.

The second edition, released in March, was expanded to be more comprehensive and Turrentine expects similar response to it; he's already planning the third edition.