Santa Cruz surgeon's pioneering procedure removes organs throug...

Salvay refers to the traditional large incision surgery without comparing to the already minimally invasive (& with quick recovery) common 3 port procedure that the rest of the surgeons in town already perform.

To be sure, this single port option is an interesting technology - but, we currently have other laparoscopic options widely available that get people back to their lives quickly. I'm concerned people in town will not realize this after reading this article.

This article makes it sound like the Da Vinci robotic surgical system to perform hysterectomy is simple and inconsequential.
It describes this gynecologist controlled robotic surgery as less invasive, implying that it is safe. If you watch the surgery being performed on the Da Vinci web site (click on the video for physicians, not the sanitized patient version) you will quickly see that this is highly invasive destructive surgery.
Hysterectomy is the surgical removal of the uterus, a reproductive, sexual, hormone responsive organ that supports the bladder and bowel. Whether the surgery is performed abdominally, vaginally, hands-on laparoscopically or laparoscopically by a gynecologist controlled robot, a hormone responsive sex organ is removed, the vagina is shortened, and there is a loss of support to the bladder and bowel. Women who experienced uterine orgasm before the surgery will not experience it after the uterus is removed.
When the uterus only is removed women have three times greater incidence of cardiovascular disease than women with an intact uterus. When the ovaries are removed the incidence seven times greater.
There are 22 million women in the United States whose female organs have been surgically removed. Only about 2% were life saving and 98% were elective, a euphemism for unwarranted. Girls and women are not educated about the functions of female organs and they are not informed about the adverse effects of hysterectomy that have been well documented in medical literature for over a century.
Women who might ignore this promotion in a commercial advertisement will be vulnerable to believing there are no adverse effects of the surgery. An article that makes hysterectomy sound simple and inconsequential is dangerous to women.
Read the new book THE H WORD, and find out what the medical literature documents about the well-known consequences, and what women report about the effects of hysterectomy on their bodies, their health and their lives, and read the Adverse Effects Data at http://www.thehword.org .

Thanks Nora for this information. It does seem to me that we have "surgeries du jour" that become somewhat fashionable. All of the sudden, everyone's got a diagnosis that can be cured by the latest surgical technique. Don't get me wrong, I've seen surgeries that are truly miraculous, I'm speaking more to the things that may not be necessary. These procedures are expensive and, I think, part of why our medical insurance systems are out of control. I would love to see more emphasis on prevention, personally.

I'm glad to hear Dr. SALVAY is developing a method to cause even less trauma to surgical patients, and which helps to speed recovery time. As a former patient, I am forever indebted to HOWARD for turning my breech baby while still in the womb, allowing me to give birth with a normal presentation. Thanks HOWARD!!

LOVE Dr. Salvay!!! He is the BEST!!

Perpetuating the myth that surgeries have become benign, cure all interventions is superficial and wrong.OB/GYNS are famous for doing all sorts of unnecessary procedures...let's look at a few of the follies that are well documented.
#1 Cesarean delivery.Prior to the litigous frenzy created by ambulance chasers like John Edwards,rates were around 10% of total deliveries:after,C-sections account for around 30% of deliveries.The rate of fetal demise,cerebral palsy,and other adverse outcomes has not benefited from these MILLIONS of unnecessary surgeries.
#2 Episiotomy (cutting the vagina during childbirth)routinely done by many OB's(including this one).Disproven by several large,well conducted studies, to hasten delivery.Proven to increase the rate of 4th degree tears(tears that extend to the rectum,with resulting fecal incontinence and fistula formation often resulting).
Please do the research yourself,and analyze the studies... and reach your own conclusions before electing for any procedures.Only you can protect your own health.Surgeons are trained,expected, and highly paid to do surgery,not to talk people out of it.Laparoscopy may be easier,cheaper and safer than traditional 'open belly' procedures, but that doesn't address the fact that Hysterectomy and Oophrectomy procedures place women at hugely greater risk of cardiovascular disease(#1 cause of death in America for women as well as men).Carefully weigh risks and benefits.Ignore propaganda like this article.Is the single port procedure really that much better than the triple port?Perhaps women better spend more time looking at the consequences and alternatives, rather than a minor variation of technique...
Ask yourself how much the surgeon gets paid to do the surgery,versus office visits.

I had a number of complications with my daughter's birth. With Dr. Salvay's help, I had an uncomplicated labor and birth and could focus on my healthy baby girl immediately.

I had an episiotomy. I needed it. And I wish I hadn't taken the anti-episiotomy crowd so seriously before-hand. Someone with my complications would have died in childbirth 50 years ago.

I would trust him with this procedure, because he considers what's best for the individual. Which may not be what's "trendy" at the moment.

Dr. Salvay did my Hysterectomy 10 years ago. I couldn't be happier. Best decision I ever made.

Dr. Salvay was already ahead of the game back in 1994, when he performed a procedure only done by a few physicians in all of California. It required learning new procedures, was less invasive and most importantly - cost less to perform. That might be one of the major reasons other surgeons are not interested. This procedure was a blessing for my health. Thank you Dr. Salvay.

Becky Johnson wrote:

Thanks HOWARD!!

Did he remove your HEART while he was at it? That would explain A LOT about you.

Salvay is a local treasure. Responsive to patients and a brilliant technician. We're lucky to have him in our community.

A large study at UCD reviewed 20,000 deliveries and found no hastening of delivery times with episiotomy.Many OBs are trained to do them routinely, and continue the practice regularly-in spite of the science to the contrary.Tons of our friends in town say he cuts them right and left.Patients are afraid,and don't know the studies.Much like the primitives who thanked the priests for 'making the sun come up again',mothers with a healthy baby thank the OB for 'saving them'....if this were true,where's all the dead babies from the homebirths?.If these procedures need to be done, then why do midwives/homebirths have such favorable outcomes, with much fewer surgical procedures?Keep your scizzors out of my wives vagina please,I've got other funner and healthier activities planned.Here's a middle of the road review:I'd at least limit the procedure to these guidelines.
An episiotomy is a surgical incision through the perineum made to enlarge the vagina and assist childbirth. It is one of the most common medical procedures performed on women.
The primary rationale behind an episiotomy is related to the nature rather than the size of the tear. Many physicians use episiotomies because they believe that it will lessen perineal trauma, minimize postpartum pelvic floor dysfunction by reducing anal sphincter muscle damage, reduce the loss of blood at delivery, and protect against neonatal trauma. In many cases though, episiotomies cause all of these problems.[1] Research has shown that natural tears typically are less severe
Episiotomy is indicated if:
* The baby's shoulders are stuck (shoulder dystocia) a bony association, though the episiotomy does not resolve this problem, it allows the operator more room to perform maneuvers to free shoulder from the pelvis.
* There is a serious risk to the mother of second or third degree tearing
* In some cases where a caesarean section is not indicated but delivery is adversely affected
*'Natural' tearing will cause an increased risk of maternal disease being vertically transmitted
* The baby is very large
* Rigid perineal muscles
* When instrumental delivery is indicated
* When a woman has undergone FGM (female genital mutilation) an anterior and or mediolateral episiotomy may be indicated.
* Prolonged late decelerations or fetal bradycardia during active pushing
[edit] Controversy about common usage
In various countries, routine episiotomy has been accepted medical practice for many years. Since about the 1960s, routine episiotomies have been rapidly losing popularity among obstetricians and midwives in Europe, Australia and the United States. A nationwide US population study[3] suggested that 31% of women having babies in U.S. hospitals received episiotomies in 1997, compared with 56% in 1979. In Latin America it remains popular, and is performed in 90% of hospital births,[4] in most cases without the mother's consent. This procedure is not helpful for routine patients[5] Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating, particularly in midline episiotomies [6]. In addition it may complicate sexual intercourse by making it painful [7] and replacing erectile tissues in the vulva with fibrotic tissue.
In cases where an episiotomy is indicated, a mediolateral incision may be preferable to a median (midline) incision as the latter is associated with a higher risk of injury to the anal sphincter and the rectum[8].
[edit] Impacts on sexual intercourse
Some midwives compare routine episiotomy to female circumcision.[9] One study found that women who underwent episiotomy reported more painful intercourse and insufficient lubrication 12–18 months after birth, but did not find any problems with orgasm or arousal.[10]

He nearly killed my wife. And he's known to have the worst bedside manner in the area.

live oak gal wrote:

Dr. Salvay did my Hysterectomy 10 years ago. I couldn't be happier. Best decision I ever made.

Most folks, including doctors, don't know that fibroid-related problems in the breasts, uterus, and ovaries are the result of not enough iodine in the diet. These problems are virtually non-existant in Japanese women who adhere to a traditional diet which includes lots of sea vegetables, which are high in iodine. Woman w/ fibroid problems have been cured by taking effective iodine supplements. Iodorol is one of the best. This link is especially important because fibroid tissue in breasts and reproductive parts is considered a precursor to cancer. It's always better to try and heal the body naturally before removing body parts. Surgery should be the last resort, after detoxification and nutritional remedies have been thoroughly tried.

You can say that again. Actually, most surgeons have various successes and failures. Maybe you got him on a bad day. But I agree with you about his manners.

If they aren't doing it at Stanford, I consider that a huge "Do Not Pass Go" card. Add to that the uber-ego aspect -- "I'm trying to set myself up to be the West Coast guy," Salvay said -- and you are looking at a situation in which it is far too likely that the patient's health and safety is not the primary concern.

Scary and infuriating at at the same time.

Humility is an undervalued (and therefore rare) trait in physician, and especially in surgeons. Salvay is not a humble man, I can tell you.

(And to the woman who was happy to be "sleeping on my stomach in a week"...that posture is going to wreck your back and neck!)

SB "are not the primary concern..."

good4you wrote:

He nearly killed my wife. And he's known to have the worst bedside manner in the county.
<quoted text>

Not just bedside, but "table" side as well...as in that stirrupped table in the examination room. A cold man.

Surgery Has Dark Side Too wrote:

Perpetuating the myth that surgeries have become benign, cure all interventions is superficial and wrong.OB/GYNS are famous for doing all sorts of unnecessary procedures...let's look at a few of the follies that are well documented.
#1 Cesarean delivery.Prior to the litigous frenzy created by ambulance chasers like John Edwards,rates were around 10% of total deliveries:after,C-sections account for around 30% of deliveries.The rate of fetal demise,cerebral palsy,and other adverse outcomes has not benefited from these MILLIONS of unnecessary surgeries.
#2 Episiotomy (cutting the vagina during childbirth)routinely done by many OB's(including this one).Disproven by several large,well conducted studies, to hasten delivery.Proven to increase the rate of 4th degree tears(tears that extend to the rectum,with resulting fecal incontinence and fistula formation often resulting)...

Wait a minute there, SHDST. Cesareans have become more common, it's true. But you neglect to mention that there are many reasons for it. More older women are having more babies -- and these are often their FIRST babies -- often in multiples. Women who not too long ago would have not been able to carry long enough to give birth to a viable baby are now doing so, and will often need a Cesarean to deliver that (often) premature child. And there are the women who just want to schedule a "procedure" rather than go through the pain and unpredictability of vaginal birth. You can't blame a doctor for a choice that falls on the mother. It's true that the bar for advising a Cesarean over a vaginal birth has been lowered due to liability issues. But it's not that simple.

Second, my sister had a 4th Degree tear in one of her pregnancies, and it was because the doctor WOULDN't do an episiotomy. She requested one, and she was refused. And she tore.

Can occur with or without episiotomy.Studies show 4* tears are more common with, one of the main reasons for the procedures decline.Every patient of his you talk to, said he did it regardless of pt input.Once you walk in the doors of the OR- you just lost control.If you want to have any say, you better get a midwife and do it at home.

The meteoric rise in the C-section rate from 8% to 30% can be directly traced to Edwards landmark $80,000,000 malpractice lawsuit award.The data shows no rise in adverse outcomes 40 years ago when this began.Fertility Tx like IVF ,ICSI etc have increased multiparous and older mothers, but the increased c-section rate is seen in younger, single fetus cases.

Lots of women have really tough times with heavy and irregular bleeding around menopause.If you can tough out a few years with medical therapy...the storm will likely pass.If you cut out the ovaries and uterus, your troubles with increased risk of heart disease and osteoporosis /hip and back fractures, have just begun.The chance to cut,may not be the chance to cure.