Minimally Invasive Obstetrics-Gynecology Surgery

Laparoscopic and minimally invasive surgery has become commonplace in operating rooms throughout the United States, and minimally invasive gynecology has gained enormous momentum within the specialty.

Advances in computer technology and laparoscopic instruments have allowed CMMC surgeons to offer a minimally invasive approach to a much broader range of patients. Many gynecological surgeries now require no incisions or only a few tiny incisions, and the majority of these surgeries are outpatient procedures. You return home the same day and are back to your regular activities within just a few days. Our patients benefits in other ways as well: they suffer less pain and discomfort than they would after traditional, open surgeries, which requires large incisions.

Today many procedures can be successfully conducted by a minimally invasive approach including:

  • Hysterectomy (removal of the uterus)
  • Oophorectomy (removal of the ovaries)
  • Myomectomy (removal of the fibroids)
  • Treatment of endometriosis and pelvic pain

Minimally invasive gynecological surgeries require special surgical tools.

Laparoscope: A thin, fiber-optic tube with a tiny video camera on the end. The surgeon inserts the laparoscope through a small incision in the navel and guides it to the problem. The surgeon then inserts tiny surgical instruments through other small incisions to perform the operation.

Hysteroscope: A thin, telescopic tube used to see the inside the uterus. No incisions are needed with a hysteroscope. The surgeon inserts the hysteroscope through the vagina and into the uterus. Small surgical instruments can be inserted through the hysteroscope to perform an operation.

Each member of our highly skilled team of surgeons is dedicated to providing individualized, minimally invasive surgery options to diagnose and treat a range of gynecologic conditions, improving our patients quality of life.

At CMMC, our world-class surgeons treat the following gynecological issues with minimally invasive techniques:

  • Abnormal Menstrual Bleeding
  • Endometriosis
  • Fibroids
  • Hysterectomy
  • Incontinence
  • Infertility
  • Ovarian cysts
  • Pelvic pain
  • Sterilization
Abnormal or Heavy Menstrual Bleeding

Abnormal menstrual bleeding is a common issue, which can be caused by any of the following:
  • Cervical or endometrial polyps
  • Heavy, irregular or abnormal periods (menorrhagia)
  • Peri- or post-menopausal bleeding
  • Uterine fibroids

Some issues can be treated with the appropriate medication. Other treatment options will depend on the cause, as well as a woman's age and individual desires, which might include plans for future pregnancies. Some women find relief after uterine scraping (D&C) or when fibroids are removed.

For women who no longer want to become pregnant, endometrial ablation is a common option. This hysteroscopic procedure destroys the lining of the uterus so a woman cannot menstruate. A very quick procedure, endometrial ablation requires only minimal anesthesia.

Endometriosis

Endometriosis is a disorder in which tissue that normally lines the inside of your uterus the endometrium grows outside your uterus (endometrial implant). Displaced endometrial tissue continues to act as it normally would thickening, breaking down, and bleeding with each menstrual cycle. Because this displaced tissue has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions.

Endometriosis can cause pain sometimes severe especially during menstruation. Fertility problems also may develop. Issues that can arise with endometriosis include:

  • Adenomyosis - a uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.
  • Painful periods (dysmenorrhea)
  • Pelvic inflammatory disease (PID)
  • Pelvic scar tissue (adhesions)

Fortunately effective treatments for endometriosis are available. At CMMC, our surgeons treat endometriosis with the following laparoscopic techniques:

  • Laparoscopic ablation destroys the endometrial implants and removes adhesions
  • Removal of ovarian cysts
  • We also offer laparoscopic uterosacral nerve ablation (LUNA), which involves cutting some of the nerves on the uterus that may be responsible for pelvic pain.
Fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). Ranging dramatically in size, fibroids can grow slowly, rapidly, or not at all. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.

As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms.

If uterine fibroids cause pain, heavy bleeding, or infertility, surgery is frequently the best option. The following minimally invasive approaches leave the uterus intact, allowing a woman to become pregnant after the operation.

  • Endoscopic myomectomy, which removes fibroids using a laparoscope
  • Hysteroscopic resection, or the removal of fibroids using a hysteroscope. This procedure is an option for fibroids located inside the uterine cavity.

The surgical approach used to remove a uterine fibroid depends on the size of the growth. Large fibroids may require conventional open surgery.

Hysterectomy

Our talented surgeons employ new minimally invasive approaches that promise much shorter recovery times and much less discomfort than traditional operations for hysterectomies:
  • A laparoscopic assisted vaginal hysterectomy (LAVH) removes the uterus, ovaries, and fallopian tubes through the vagina.
  • A cervix-sparing hysterectomy removes the uterus, ovaries, and fallopian tubes through a small incision

Incontinence

Surgery can significantly improve urinary incontinence. Using laparoscopic surgical approaches, our surgeons can reposition or secure the bladder to prevent leaking of urine.

Infertility

Using the latest laparoscopic and hysteroscopic techniques, our talented team of surgeons is able to diagnose and treat infertility. Minimally invasive techniques can, for example, alleviate endometriosis and blocked fallopian tubes. We are also able to reverse a past tubal ligation, which will allow a woman to become pregnant again.

Ovarian Cysts

Ovarian cysts are a common problem and can almost always be surgically treated using minimally invasive approaches without removing the ovary.

Pelvic Pain

Our surgeons use minimally invasive approaches to diagnose and treat the various causes of pelvic pain.

  • Laparoscopic surgery can be used to remove pelvic adhesions and other abnormal tissue.
    Laparoscopic uterosacral nerve ablation (LUNA) severs some of the nerves on the uterus that may be responsible for pelvic pain.

Sterilization

In addition to tubal ligation, CMMCs surgeons offer women the latest non-surgical approach to sterilization. Using a hysteroscope, our surgeons plug the fallopian tubes, which prevent pregnancy from occurring. No incision or anesthesia is necessary.