Gynecological Services/Procedures Performed

Minimally Invasive Surgery is the use of surgical techniques, either laparoscopic or vaginal, that employ small "port" incisions for laparoscopic use or intravaginal incisions, avoiding larger abdominal incisions that result in more pain, longer hospitalization, slower recovery and possibly increased complications. These "ports" provide entry into the abdomen for the use of visual aids (laparoscope) and many instruments that can grasp, cut and coagulate tissue, allowing the surgeon to perform complex procedures previously only done with the traditional "open" abdominal incisions. 

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Laparoscopic Hysterectomy, (total or partial) is a laparoscopic procedure for removing the uterus through small abdominal incisions or through the bellybutton using three 5 mm. incisions. The entire uterus can be removed (TLH, total laparoscopic hysterectomy) or the cervix can be left in place (LSH, laparascopic supracervical hysterectomy.) With both procedures, the ovaries can be removed if needed or desired without additional incisions. Laparoscopic hysterectomies are done under general anesthesia and many times as outpatient. The recovery is from 1-3 weeks, with restriction on vaginal intercourse for 6 weeks in TLH cases.

For most women, the laparoscopic hysterectomy offers numerous potential benefits over traditional surgical approaches, including:

  • Significantly less pain
  • Less blood loss and need for transfusion
  • Less risk of infection
  • Shorter hospital stay
  • Quicker recovery and return to normal activities
  • Smaller incisions and minimized scarring
  • Better outcomes and patient satisfaction, in most cases.

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Hysteroscopic Myomectomy is the removal of fibroid tumors with the use of the hysteroscope allowing resection of fibroids that protrude into the cavity of the uterus. This approach does not involve abdominal incisions and is done through the vagina. Occasionally it is performed in conjunction with a laparoscopic myomectomy for removal of larger fibroids usually to treat abnormal menstrual bleeding or infertility. It can be done on an outpatient basis.

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Laparoscopic Myomectomy is the removal of fibroid tumors from the uterus using laparoscopic techniques avoiding a large "open" incision. The use of special instrumentation allows this minimally invasive procedure to preserve the uterus. It is usually performed for abnormal menstrual bleeding, pain or infertility or in cases where hysterectomy is not desired. This procedure requires extensive advanced laparoscopic skills and can be done in an outpatient setting.

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Endometrial Ablation is a minimally invasive procedure to treat heavy menstrual bleeding done with minimal anesthesia, occasionally in an office setting. The procedure involves the use of energy to destroy the endometrium (lining of the uterus) which is responsible for menstrual bleeding. Several different devices using different energy modalities exist to accomplish reduction in menstrual flow or in many cases complete cessation of menses (amenorrhea). Novasure ablation uses a device inserted into the uterus through the cervix and applies heat energy for approximately 90 seconds to achieve the destruction of the endometrium leading to reduction of menstrual flow.

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Cone Biopsy is an extensive form of a cervical biopsy. It is called a cone biopsy because a cone-shaped wedge of tissue is removed from the cervix and examined under a microscope. A cone biopsy removes abnormal tissue that is high in the cervical canal. A small amount of normal tissue around the cone-shaped wedge of abnormal tissue is also removed so that a margin free of abnormal cells is left in the cervix. 

A cone biopsy is usually done as an outpatient procedure (you do not have to spend a night in the hospital). It is done after a pap test shows moderate to severe cell changes and 

  • The abnormal tissue cannot be seen with colposcopy but was found in cells collected from a biopsy of the cervical canal, or the abnormal tissue seen with colposcopy extends high into the cervical canal. A cone biopsy is done to remove and examine the abnormal tissue.
  • The abnormal cells found on a pap test cannot be seen with colposcopy or found in cells collected from a cervical biopsy. The cone biopsy may be used to diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
  • Cervical cancer is suspected based on pap test results, colposcopy, and cervical biopsy. A cone biopsy can determine the extent, depth, and severity of the cancerous tissue and can guide treatment decisions. 

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For more information on conditions or treatments, please see our patient education links.

 

Information on this website is for educational and reference purposes only and should not be interpreted as specific medical advice.


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