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"
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
- Significantly less pain
- Less blood loss and need for transfusion
- Less risk of infection
- Shorter hospital stay
- Quicker recovery and return to normal
- Smaller incisions and minimized scarring
- Better outcomes and patient
satisfaction, in most cases.
return to top
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.
return to top
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.
return to top
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.
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.
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
- 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.
return to top
For more information on conditions or
treatments, please see our patient