What is minimally-invasive gynecological surgery?

Minimally invasive surgery is performed using scopes rather than large incisions. A laparoscope or hysteroscope is used to perform the particular minimally invasive surgery.

If a medical therapy is not available or fails the GYN surgical literature demonstrates that at Minimally Invasive Gynecologic Surgery(MIGS) sub-specialty centers over 99% of women with fibroids, abnormal bleeding, adenomyosis, endometriosis, benign appearing ovarian cysts, pelvic prolapse, and other GYN indications for surgery or hysterectomy are candidates for MIGS instead of open abdominal surgery. We offer the most minimally invasive of minimally invasive surgeries.

Which GYN issues might require surgery?

It is possible to offer a patient a less invasive, less painful surgery in the vast majority of cases. Some of these procedures include: 

• Removal of fibroid tumors
• Hysterectomy
• Excision of endometriosis
• Abnormal bleeding
• Ovarian cysts
• Infertility surgery
• Pelvic prolapse
• Incontinence
• Pelvic pain

What types of minimally-invasive GYN surgery do you offer?

• Laparoscopic(L/S) Surgery: The laparoscope is a narrow scope with multiple lenses used to look inside the abdomen. The scope has a video camera attachment so that the surgeon can view the abdominal and pelvic cavity without a large incision. The picture of the internal structures is projected onto a video monitor like a TV. Other instruments can be inserted through 2-3 accessory ports. The incisions are 1/4 to 1/2 inch or smaller. Because there are only a few small incisions rather than a single large incision, the patient is usually able to go home the day of the operation. Open abdominal surgery requires an incision of 4-8 inches( 1 inch = 25 mm) . L/S surgery can be performed using 4 access ports. Trocars are the ports that are placed through the wall of the abdomen so surgical instruments can be inserted and removed easily and rapidly. A 5 mm trocar is placed at the base of the belly button so a scope can be inserted and contents of the abdominal cavity are then seen on an HD monitor a few feet away. On the left and right, just above the pubic bone, we insert 5 mm trocars. The largest trocar is 12 mm and is in the midline just above the pubic bone. Using the scope to see we perform the GYN operation the woman needs. Instead of days in the hospital and weeks off work our procedures are outpatient with only days off work. A woman can have a hysterectomy on Thursday and return to a desk job on Monday.

  

  Open abdominal surgery

  
• Hysteroscopic(H/S) Surgery: Hysteroscope- The hysteroscope is a small scope that is inserted through the cervix and into the uterine cavity to remove fibroids, polyps, or perform infertility surgery. Because there are no abdominal incisions, the recovery after hysteroscopic surgery is faster than after laparoscopy, and much faster than an abdominal incision. In some cases, a woman may have to have a combined hysteroscopic and laparoscopic surgery.

  

At the Advanced Women’s Health Institute, we do not prescribe robotic procedures. Most scientific publications agree that robotic surgery takes longer, costs more to perform, and is more painful. AWHI offers the least invasive procedures possible, and we are always searching for innovations to improve your patient experience.

How is minimally invasive surgery different from general OB/GYN surgery?

Minimally invasive surgery reduces the healing time to days or weeks instead of weeks and months. Because of the tiny size of the incisions, or possibly no incisions, the woman is able to go home the same day, and will have a much faster recovery than if a large abdominal incision were made. Laparoscopic surgery is less painful and has a faster recovery than traditional open abdominal surgery. There is always the risk of complications in any surgical procedure, whether it is open abdominal surgery or minimally invasive surgery. Surgical literature demonstrates lower rates of complications for minimally invasive surgery compared to open surgery.

• Less pain
• Faster Recovery Time
• Most surgeries are performed on an outpatient or extended recovery basis

Will I need anaesthesia during my surgery?

For hysteroscopic surgery, a general anesthetic is not necessary. The patient may choose this form of anesthesia, but it is possible to perform hysteroscopic surgery under an epidural or spinal block, or with IV sedation.

Is minimally-invasive surgery safe?

Minimally invasive surgery does not mean less risk. The incisions are small so there is less pain and a faster recovery but it is still the same surgery inside. Complications are possible in any surgery. However, studies report less risk of major complications with minimally invasive surgery compared to pen surgery.