Dancer Escapes Scars with Single-Incision Laparoscopy May 25, 2011

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When you're a belly dancer, the area around your navel gets a lot of attention. Surgical scars are something most dancers want to avoid. So who better to do your serious abdominal surgery than another dancer who can empathize with your concerns and perform single-incision laparoscopy?

Dental hygienist Angie Carpenter suffered from painful, frequent menstrual periods, causing her to miss days of work each month. Her patients are scheduled six months out and missing work makes it challenging to fit everyone in.

The severe pain and heavy bleeding also forced her to sit out of belly dancing practice and postpone weekend motorcycle rides. At age 37, Angie was weak, anemic and not enjoying life as fully as she would like.

In February, she made an appointment to see Dr. Diana Wang, a gynecologist with University of Texas Physicians Group. Dr. Wang, a former dancer with Ballet Austin, listened to Angie's symptoms and laid out all the options to treat her condition. They settled on a hysterectomy.

Angie voiced her concerns about getting back to work quickly and avoiding more scarring on her abdomen. They discussed vaginal, laparoscopic and abdominal hysterectomies. An abdominal hysterectomy could use the same incision from her cesarean section, just above her bikini line and mostly out of sight. However, it takes nearly six weeks to recover.

Although much less invasive, traditional laparoscopy, including newer robotic-assisted laparoscopy, still requires three to four small incisions on the abdomen. In comparison to an abdominal hysterectomy, this approach offers a significantly shorter recovery period. However, it would leave scars higher up on Angie's abdomen, visible with her belly dancing costume.

Dr. Wang also employs single-incision laparoscopy, the latest approach to performing a laparoscopic hysterectomy. It requires only one incision in the belly button, using a device with multiple ports to insert a camera and surgical instruments. There are very few muscles behind the belly button, making recovery much faster. Patients can get back to work and everyday activities within two weeks.

The cosmetic results are very appealing; the incision disappears within the wrinkles of the belly button. However, it's the speedier recovery and decreased risk of infection that is most attractive to Wang and many of her patients.

"If I can do this and it creates a better outcome for the patient, why not?" Dr. Wang said. "Patients experience less pain, benefit from faster healing and the added bonus is that it's aesthetically pleasing."

Dr. Wang, who also serves as assistant professor for The University of Texas Southwestern - Austin, is the first to introduce this newer, single-incision laparoscopic technique to OB/GYN residents at University Medical Center Brackenridge.

"Working with one port can be a difficult skill to master; however, I am extremely pleased with how quickly the residents have adapted to this newer technique," Dr. Wang said.

Dr. Kim Marshall, fourth-year resident, was the first from her class to apply the new skill.

"It requires us to rearrange our minds and think differently," Dr. Marshall said. "We come at tissue from a different angle and use different movements to ensure our instruments are in the right place. I feel fortunate for this opportunity to learn a cutting-edge procedure that improves post-operative results for patients."

Angie elected to have the single-incision laparoscopy in late April. She was back to work within two weeks and walked away without a visible scar.

"This recovery was night and day different from my C-section," Angie added. "The pain was almost non-existent. I stayed one night in the hospital and refused all of my pain medication. The next week I was working in my garden and able to use the elliptical machine at my gym."

Now, only six weeks post-surgery, Angie will perform with her dance group, Desert Passion Middle Eastern Dance Theater, at the Austin Belly Dancing Convention the first week in June.

Diana Wang, MD

Assistant Professor - University of Texas Southwestern Austin Programs

Diana Wang, MD graduated from the Plan II Honors program at UT Austin, then went on to study medicine at the University of Texas Medical Branch in Galveston. She completed her Obstetrics and Gynecology Residency with the UTMB Austin program, and as one of the first resident physicians in the nation to be trained on the Da Vinci Robotic Surgical System, Dr. Wang has special interest and skill in minimally invasive surgery and is committed to staying on the cutting edge of advanced surgical techniques to better women's lives. She is the 2009 recipient of the Arnold P. Gold Foundation Humanism and Excellence in Teaching Award.

As a former dancer with Ballet Austin, Dr. Wang continues to perform and choreograph in her leisure. She is fluent in both Mandarin Chinese and Spanish.

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