Surgical Procedures

Endometrial Ablation

Endometrial ablation is a medical procedure that is used to remove (ablate) or destroy the endometrial lining of a uterus. This technique is most often employed for people who suffer from excessive or prolonged bleeding during their menstrual cycle but cannot or do not wish to undergo a hysterectomy. The procedure is most commonly done on an outpatient basis and can often be done in clinic. The endometrial ablation procedure we perform in our office is called Novasure. NovaSure® is an endometrial ablation (EA) procedure that can reduce or stop menstrual bleeding. It works by removing the endometrium, or the lining of the uterus (the part that causes the bleeding), with a quick delivery of radiofrequency energy. Anesthesia is used when performing this procedure in our office. Your doctor will explain the risks of all treatment options. NovaSure is for premenopausal women with heavy periods due to benign causes who are finished childbearing. Pregnancy following NovaSure can be dangerous. So it is not recommended that a patient get pregnant after and endometrial ablation.

Hysterectomy

A hysterectomy is a surgery to remove a woman's uterus or womb. Your fallopian tubes and ovaries may or may not be removed during your hysterectomy. This will depend on several factors including your condition and age. After a hysterectomy, you no longer have menstrual periods and cannot become pregnant. Hysterectomy is the second most common surgery in women.

Hysterectomy may be needed if you have:

  • Cancer of the uterus, ovary, cervix, or endometrium
  • Fibroids
  • Endometriosis
  • Prolapse of the uterus
  • Adenomyosis
  • Chronic pelvic pain
  • Abnormal vaginal bleeding

There are different ways that your doctor can perform a hysterectomy. It will depend on your health history and the reason for your surgery.

  • Abdominal hysterectomy. This is done through a 5- to 7-inch incision, or cut, in the lower part of your belly. The cut may go either up and down, or across your belly, just above your pubic hair.
  • Vaginal hysterectomy. This is done through a cut in the vagina. The doctor will take your uterus out through this incision and close it with stitches.
  • Robotic-assisted surgery or da Vinci Hysterectomy. Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limitations of traditional surgery – da Vinci Surgery. Using state-of-the-art technology, a da Vinci® Hysterectomy requires only a few tiny incisions, so you can get back to your life faster.

Recovering from a hysterectomy takes time. Most women stay in the hospital from 1 to 2 days for post-surgery care. Some women may stay longer, often when the hysterectomy is done because of cancer.

The time it takes for you to resume normal activities depends on the type of surgery. If you had:

  • Abdominal surgery. Recovery takes from 4 to 6 weeks. You will gradually be able to increase your activities.
  • Vaginal or laparoscopic surgery. Recovery takes 3 to 4 weeks.  

Laparoscopy

Laparoscopy is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery. Laparoscopy is a minimally invasive surgical technique. It is normally performed in the outpatient surgery unit of a hospital. In most cases, patients can return home a few hours after a laproscopic procedure.

Laparascopic surgery can be used to diagnose and treat endometriosis, remove ovarian cysts, diagnose and treat adhesions or scar tissue, and perform sterilization (getting your tubes tied).

Pelvic Prolapse repair

Pelvic prolapse occurs when the pelvic floor muscles become weak or damaged and can no longer support the pelvic organs. Types of prolapse include: Cystocele (bladder prolapse), Enterocele (prolapse of the small bowel), Rectocele (prolapse of the rectum or large bowel), Uterine Prolapse (Uterine prolapse is when the womb drops down into the vagina.).
Symptoms of prolapse include:

  • pain or discomfort is interfering with your daily activities
  • sex becomes painful
  • you can feel or see something bulging out or just inside of your vagina
  • you have any unusual bleeding or discharge

Pelvic prolapse is rarely a life-threatening condition. However, most prolapses gradually worsen and can only be corrected with intravaginal pessaries or surgery.  

D&C

D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilation ("D") is a widening of the cervix to allow instruments into the uterus. Curettage ("C") is the scraping of the walls of the uterus.

This procedure may be done to:

  • Diagnose conditions such as uterine cancer
  • Remove tissue after a miscarriage
  • Treat heavy menstrual bleeding or irregular periods

Your doctor may also recommend a D and C if you have:

  • Abnormal bleeding while on hormone replacement therapy
  • An embedded intrauterine device (IUD)
  • Bleeding after menopause
  • Endometrial polyps 

CKC

A Cold Knife Cone biopsy (conization) is surgery to remove a sample of abnormal tissue from the cervix.  The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Abnormal changes in the cells on the surface of the cervix is called cervical dysplasia. This procedure is done in the hospital. You will be placed under general anestheisa (asleep and pain-free), or you will be given medicines to help you relax and feel sleepy. Cold knife cone biopsy is done to detect cervical cancer or early changes that lead to cancer.

Cold knife cone biopsy may also be used to treat:

  • Moderate to severe types of abnormal cell changes (called CIN II or CIN III)
  • Very early stage cervical cancer (stage 0 or IA1)  

Myomectomy

Myomectomy is a procedure in which uterine fibroids are surgically removed from the uterus.  Uterine fibroids (also known as myomas) affect 30% of women.  While many fibroids do not need treatment, others can cause abnormal uterine bleeding, pressure, pain, or other symptoms. 

Removing the entire uterus (hysterectomy) is frequently done to treat fibroids, but many women are looking for alternatives to hysterectomy if they wish to have children or simply do not want to lose their uterus. 

Oopherectomy

Oophorectomy is a surgical procedure to remove one or both of your ovaries. Your ovaries are almond-shaped organs that sit on each side of the uterus in your pelvis. Your ovaries contain eggs and produce hormones that control your menstrual cycle.

Oophorectomy can be done alone, but it is often done as part of a larger surgery to remove the uterus (hysterectomy) in women who have undergone menopause. Oophorectomy is also commonly combined with surgery to remove the nearby fallopian tubes (salpingectomy), since they share a common blood supply with the ovaries. When combined, the procedure is called salpingo-oophorectomy.  

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