Minimally Invasive Surgery
Advances in surgical techniques and equipment are giving women more options to consider when discussing gynecological issues with their physician. These are some of the newer procedures we offer our patients:
Open Supracervical Hysterectomy (also called "Subtotal Hysterectomy" or "Partial Hysterectomy"): Removes the uterus but leaves the cervix in place, which some research suggests may reduce the risk of pelvic organ prolapse and preserve sexual function.
For this procedure the surgeon uses a thin, lighted telescope-like instrument called a laparoscope along with several long, slender surgical instruments that are all inserted through 3 to 4 tiny incisions in the belly button and abdomen. Using these instruments, the surgeon carefully separates the uterus from the cervix and surrounding organs and removes it through one of the openings. The cervix is left in place.
For more information on this minimally invasive procedure, please visit Ethicon's Women's Health & Urology website on Laparoscopic Supracervical Hysterectomy (LSH) information.
Endometrial ablation is a safe and effective treatment for patients suffering from heavy periods due to benign causes. This procedure involves burning or vaporizing the lining of the uterus (the endometrium) and up to 90% of women who have this procedure are satisfied with their results. After the procedure, the majority of women usually have lighter periods and a small number of those may have their periods stop completely. Pretreatment testing may include a Pap smear, a pelvic ultrasound, and/or an endometrial biopsy.
Two popular types of endometrial ablation are Gynecare Thermachoice® and NovaSure®. To learn more about these minimally invasive procedures please visit their websites: Gynecare Thermachoice® and Novasure®.
Patient Brochure: Thermachoice: Treatment Options for Heavy Periods [pdf]
Urine leakage has not always been satisfactorily addressed in the past. Now more than ever, our range of treatment options has grown - these include possible use of Kegel exercises, medications, surgery, pessaries, and/or physical therapy. Lifestyle changes, such as losing weight, quitting smoking, and avoiding caffeine, may also improve urinary incontinence. We also have better tests to evaluate voiding, such as urodynamics.
The tension free vaginal tape (TVT) procedure is a revolutionary technique that places a meshlike tape under the urethra, the tube that drains the bladder, to keep it in a more normal position. The tape is inserted through a tiny incision in the vagina and 2 tiny incisions on the lower abdomen or a tiny incision on each inner thigh. The newest TVT, the TVT Secur, has only a single incision in the vagina. Over 80% of women note dramatic improvement in their stress urinary incontinence (SUI) after their surgery.
The type of tension free vaginal tape procedure - the TVT, the TVT-Obturator approach, and the TVT Secur - that may be offered to you will depend on your situation and your physician's preference.
For more information on this minimally invasive procedure, please visit WebMd or visit Ethicon's Women's Health & Urology website.
Patient Brochure: Gynecare TVT-Secure System
There are two types of non-hormonal, "no cut" methods of female permanent sterilization. The procedure is usually done with minimal or local anesthesia and, at times, may even be done in the office.. Both procedures involve inserting a a very thin, lighted telescope-like instrument called a hysteroscope is inserted into the uterus and coils or implants are then placed into each fallopian tube. During the first 3 months after the surgery, a tissue barrier develops around the coils to block the sperm from reaching the egg. Another form of birth control will need to be used for the first 3 months after the procedure until a confirmation xray test done at that time confirms that the tubes are properly blocked.
Adiana
Adiana works by stimulating your body's own tissue to grow in and around tiny, soft silicone inserts that are placed inside each fallopian tube. Adiana leaves nothing in the uterus and means it may interfere less with future gynecologic procedures and is over 98% effective in preventing pregnancy. Visit Adiana website for more information.
Patient Brochure: Adiana[pdf]
Essure
Essure works by sitmulating your body's own tissue to in around spring-like coils, called "inserts". Essure is over 99% effective in preventing pregnancy. Visit Essure’s website for more information.
Patient Brochures: Essure Patient Information Booklet [pdf] and After The Essure Procedure [pdf]
Robot-assisted surgery is an advanced form of minimally invasive surgery in that instruments and cameras are inserted through small incisions. Many difficult laparoscopic procedures, such as laparoscopic suturing, are made easier by the robot through the use of a magnified, 3D views, high definition view, and increased instrument maneuverability. The da Vinci® Surgical Systems being used in gynecologic surgery at both St. Vincents Hospital and Good Samaritan Hospital allow gynecologists to perform advanced laparoscopic surgeries using a surgeon's console connected to three robotic arms. During robot-assisted surgery, a computer translates the motions of the surgeon into computer modulated actions conducted through robotic arms.
Robot-assisted surgery can be useful in the performance of hysterectomies, removal of fibroids or ovaries while preserving the uterus, correction of vaginal prolapse, and pelvic reconstructive surgery.
For more information about minimally invasive robot-assisted surgery, please visit the daVinci® website.