Complex gynecological surgeries that once required large incisions and long recovery times are now being performed as minimally invasive procedures due to innovations as laparoscopy and robotic assistance. These advances allow surgeons to perform their procedures through tiny incisions, using a camera and small instruments. This provides surgeons with 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 greatly reduces recovery time.
A hysterectomy, the surgical removal of the uterus, is a common procedure performed each year in the United States. A traditional hysterectomy is performed through incisions in the abdomen or vagina. A newer technology is now available that allows for a simpler and less invasive procedure leaving the patient with less pain and a shorter recovery time.
A laparoscopic supracervical hysterectomy (LSH) involves making tiny incisions in the abdomen. The doctor inserts a laparoscope, a thin lighted telescope, and other surgical instruments through these incisions to carefully separate and then remove the uterus. Unlike other hysterectomies, LSH leaves the cervix intact. This can reduce the risk of later complications such as pelvic floor prolapse and urinary incontinence.
The procedure is performed on an outpatient basis, and patients can usually resume their normal activities within a week. A laparoscopic supracervical hysterectomy is not for everyone, so discuss this with your doctor to see if it is right procedure for you.
Hysteroscopy and Endometrial Ablation
A hysteroscopy is a procedure, using a tool called a hysteroscope to examine the lining of the uterus and identify, diagnose or treat abnormalities. A hysteroscopy may be performed to determine the cause of abnormal bleeding, bleeding after menopause and infertility. It may also be used to diagnose and remove fibroids or polyps and find and reposition an intrauterine device.
Endometrial ablation is a surgical procedure for those women suffering from excessive or prolonged menstrual bleeding who have not responded to other treatments and cannot or do not wish to undergo a hysterectomy.
Endometrial ablation removes or destroys the uterine lining, or endometrium, while leaving the ovaries and uterus intact. The endometrium heals by scarring, which reduces or stops future uterine bleeding. Approximately 10-20% of patients require a second procedure or hysterectomy if symptoms reappear after a re-growth of the endometrium.
Uterine Fibroid Ablation
Uterine fibroids are growths or benign masses that can form on the inside or outside of the uterus. Also known as fibroid tumors, or myomas, uterine fibroids can cause heavy menstrual bleeding, pain and pressure in the pelvis. While uterine fibroids do not always cause symptoms, they may lead to future complications and usually require treatment.
A common method used to treat uterine fibroids is a procedure called fibroid ablation. Fibroid ablation, is a minimally invasive procedure that blocks blood flow to uterine fibroids, shrinking or destroying the non-cancerous tumors that grow on the uterine walls.
Pelvic organ prolapse occurs when one or more pelvic organs prolapses, or drops from its normal location, and pushes against the walls of the vagina. This happens when the muscles in the area are weakened from either childbirth or surgery.
While this condition may be painful, it is often not serious and can even sometimes get better with time.
For pelvic organ prolapse that does not improve on its own or results in severe symptoms, surgery may be necessary to repair the problem. Pelvic prolapse repair surgery includes many different procedures, depending on which organ is affected.
These surgeries can include:
- Repair of the bladder or urethra
- Repair of the vaginal wall
- Closure of the vagina
While pelvic organ prolapse can affect women at some point in their life, it is important to consult with your doctor so that it may be treated properly and determine what you can do to prevent future recurrences.
da Vinci® Surgical System
The da Vinci® surgical system is a relatively new approach to minimally invasive surgery in which robotic techniques are used. Where laparoscopic surgery also employs a minimally invasive approach, in laparoscopy the surgeon is limited to rigid and fairly restricted movements. The da Vinci surgical system offers more flexibility and control and permits precise, effective results in a wide range of surgical procedures.
Loop electrosurgical excision procedure (LEEP) is used to treat abnormal cells found on the surface of the cervix. During the procedure, the abnormal 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 tissue removed is sent to a lab for further evaluation, including ensuring that the abnormal area has been fully removed. An assessment as to the cause of the growth of abnormal tissue will also be done. The LEEP procedure takes 20-30 minutes and can be performed in the office. A local anesthetic is administered to minimize pain.