For our patients who are considering surgery to treat a gynecologic problem, your physician may suggest a minimally-invasive procedure. We’d like to give you some information about these procedures.
What is meant by minimally-invasive gynecologic surgery?
Very simply, it is any surgical procedure that does not require an incision large enough to give the surgeon an open view of and access to the surgical site. Instead, your doctor relies on tiny microscopes and cameras to see inside the pelvis and uses tiny instruments passed through slender tubes to complete the surgery.
who can benefit from minimally-invasive surgery?
Today, nearly every woman undergoing gynecologic surgery is a candidate for a minimally-invasive procedure. Only a decade ago the majority of hysterectomies required an abdominal incision and 4 to 6 weeks of recovery. Today we estimate that about 90% of our patients needing hysterectomy avoid an abdominal incision. We were fortunate that Brookwood invested in the new technology early. Our group began using the robotic surgical system in 2009, so for us, it has become a routine part of our practice. Minimally-invasive surgery is helpful for many common gynecologic conditions when they cannot be managed with conservative treatment.
- Pelvic pain
- Abnormal bleeding
- Uterine Prolapse
- Uterine fibroids
- Urinary incontinence
- Pre-cancerous conditions of the uterus and cervix
- Benign ovarian cysts
What are the types of minimally-invasive surgery?
The hysteroscope is a thin telescope-like tube passed into the uterus through the vagina. It requires no incision. We use this procedure to examine the inside of the uterus. We can diagnose abnormal conditions of the uterus, treat abnormal bleeding, and remove scar tissue, polyps, and small fibroids from the uterus.
The laparoscope is a slender tube inserted through a small abdominal incision–usually less than a 1/2 inch. A tiny camera allows your doctor to view the inside of the pelvis. Surgical instruments can also be passed through the tube. We use the laparoscope for tubal sterilization. We can diagnose and sometimes treat endometriosis, ectopic pregnancy, ovarian cysts, adhesions (scar tissue) or other conditions via the laparoscope. Sometimes the surgeon uses the laparoscope to assist with a vaginal hysterectomy.
The da Vinci™ Surgical System is a computer-based, minimally-invasive technology commonly referred to as robotic surgery. We use robotic surgery in the treatment of many gynecologic problems. The physicians at Sparks & Favor feel that robotic surgery offers the possibility of less blood loss, less post-operative pain, shorter hospital stays, and a quicker return to your normal activities compared with traditional abdominal surgery. Read more about robotic surgery.
We are sometimes able offer a vaginal procedure to a woman needing a hysterectomy. It offers the advantages of robotic and laparoscopic surgery but requires no incision on the abdomen. Women who have had a vaginal delivery and do not have an enlarged uterus are the best candidates for this procedure. If the surgical plan involves removal of Fallopian tubes and ovaries, we generally recommend the robotic approach.
Other Minimally-invasive Procedures
- Endometrial ablation–This trans-vaginal procedure can be used to treat heavy menstrual bleeding.
- Minimally-invasive surgery for urinary incontinence (urethral sling)--This is a vaginal procedure also requiring a tiny incision at the pubic bone
- Minor procedures for evaluation and treatment of abnormal Pap tests and evaluation of abnormal uterine bleeding can be performed in our office.
What can I expect after my minimally-invasive procedure?
Some minimally-invasive procedures are performed as same-day surgery. We prefer to keep our patients overnight after a hysterectomy or other major gynecologic surgery. Individual experiences vary, but most women report that their post-operative discomfort is very manageable. Most women return to normal activities in about two weeks. (Follow your doctor’s specific recommendation about heavy lifting, intercourse, tub baths, and tampon use).