Gynecology: Surgical Procedures
Minimally Invasive Gynecologic Surgery
Complex gynecological surgeries that once required large incisions and long recovery times are now being performed as simple minimally invasive procedures thanks to such innovations as laparoscopy and robotic assistance. These advances allow surgeons to perform their procedures through tiny incisions, using a camera and small instruments. This gives surgeons a clearer and more magnified view as well as more precise control than a traditional open procedure. Today's technology makes procedures like hysterectomies and myomectomies shorter and safer, and reduces recovery tremendously.
All of our physicians are trained to perform minimally invasive gynecologic surgery.
A hysterectomy is the surgical removal of the uterus or womb, which can sometimes include the ovaries and fallopian tubes as well. This is the second most common procedure for women in the US and is performed over 600,000 times each year. It is a permanent procedure that cannot be reversed.
Although a hysterectomy is often considered a last line of defense, it can often be effective in treating reproductive conditions. Some of the reasons for a hysterectomy include:
- Uterine fibroids
- Ovarian cysts
- Uterine prolapse
- Pelvic adhesions
- Persistent pain or bleeding
Hysterectomies can be performed through several different methods, depending on the initial reason and the personal health and preferences of the patient. Many hysterectomies can now be performed laparoscopically, which requires very small incisions and a faster recovery time. Our physicians are all qualified to perform laparoscopic hysterectomies.
Abdominal and Vaginal Hysterectomy
Some patients are not candidates for laparoscopic hysterectomy due to medical reasons, and will require abdominal or vaginal hysterectomies. The surgery usually requires a 2-3 day hospital stay and full recovery is expected in 2 weeks to 2 months. Our physicians are all trained in these traditional surgical procedures.
Myomectomy is a procedure that surgically removes fibroids, non-cancerous tumors of the uterus, and repairs the uterus for women who plan to bear children or want to keep their uterus.
This procedure can be done in a few different ways, depending on the type of size of the fibroids. Laparotomy or abdominal myomectomy uses an incision and allows the surgeon to visually inspect the uterus and feel for fibroids. It requires a short hospital stay and a recovery time of 4-6 weeks. Hysteroscopic myomectomy uses a tool called a resectoscope to enter through the vagina, release a liquid to expand the uterus and then shave away the fibroid pieces. In a laparoscopic myomectomy, a small tube with a camera is inserted into the pelvis and fibroids are removed through small incisions made in the abdomen. Laparoscopic patients are usually released the same day.
Loop electrosurgical excision procedure (LEEP) is used to treat abnormal cells on the surface of the cervix. During the procedure, the cells are removed to prevent development of cervical cancer.
Wire loops attached to an electrosurgical generator cut away the affected tissue, causing the cells to heat and burst. The removed tissue is then sent to a pathology lab for further evaluation, including ensuring full removal and assessing the cause of the abnormal area. The procedure takes 20-30 minutes.
Dilation and Curettage (D&C)/ Hysteroscopy/Endometrial Ablation
Dilation and curettage is a procedure done to scrape and collect endometrium, which is the tissue inside the uterus. Dilation is the widening of the cervix which allows instruments to pass into the uterus, while curettage is the scraping of the uterine walls. This procedure is performed to diagnose and treat the cause of abnormal uterine bleeding, uterine cancer or other conditions, remove tissue after a miscarriage, perform an abortion or investigate infertility. It is performed under general or local anesthesia. A speculum is inserted into the vagina to hold it open, while a metal rod dilates the cervix. A curette is then inserted to gently scrape the tissue.
Endometrial ablation may be added to this procedure in order to effectively treat heavy uterine bleeding and may be done with through the Novasure Device and Thermal ablation.
Sterilization is a permanent method of birth control for men and women. The procedure for men is called a vasectomy and can be performed in a urologist's office.
Women have various options-Laparoscopic sterilization, hysteroscopic sterilization via Essure and postpartum sterilization.
Our physicians will guide you towards the best route for you.
If you would like more information about our Gynecology procedures or to schedule an appointment, call us directly at 703-560-1611.