Gynecologic Laparoscopic Surgery
Gynecologic surgeons were pioneers in developing laparoscopic surgery – a minimally invasive technique that uses an electronic device called a laparoscope to allow surgeons to see inside patients and perform procedures without making large incisions. Laparoscopic techniques, which do not require the large incisions of traditional surgery, can be used for a variety of pelvic procedures.
Dr. Quartell is a recognized leader in the field of laparoscopic and laparoscopic robotic gynecological surgery.
A hysterectomy is the surgical removal of the uterus or womb, which can sometimes include the ovaries and fallopian tubes as well. This is the second most common procedure for women in the US and is performed over 600,000 times each year. A hysterectomy stops the menstrual cycle and prevents pregnancy. It is a permanent procedure that cannot be reversed.
Although a hysterectomy is often considered a last line of defense, it can often be effective in treating reproductive conditions. Some of the reasons for a hysterectomy include:
- Uterine fibroids
- Uterine prolapse
- Pelvic adhesions
- Persistent pain or bleeding
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Laparoscopic Total Hysterectomy
A total hysterectomy is a common procedure that removes the uterus and cervix, and sometimes the Fallopian tubes and ovaries as well. It may be performed for many reasons, including fibroid tumors on the uterus, abnormal bleeding, endometriosis and genital prolapse and will result and will stop the menstrual cycle and prevent patients from becoming pregnant. While the traditional hysterectomy procedure involves large incisions in either the abdomen or vagina, new technology has allowed for more minimally invasive options.
A laparoscopic-assisted vaginal hysterectomy is less invasive than a traditional open vaginal or abdominal hysterectomy. While an incision is made deep inside the vagina to actually remove the uterus, a very small incision is also made in the navel to insert a laparoscope, a thin probe with a light and camera that allows the doctor to see the organs of the abdomen and pelvis while performing the procedure. This technique allows for a shorter hospital stay and faster post-operative recovery, allowing patients to return to their regular activities much sooner.
Myomectomy is a procedure that surgically removes fibroids, non-cancerous tumors of the uterus, and repairs the uterus for women who plan to bear children or want to keep their uterus. It is mainly for women who plan to bear children at a later age, when fibroid symptoms tend to occur.
This procedure can be done in a few different ways, depending on the type of size of the fibroids. Laparotomy or abdominal myomectomy uses an incision and allows the surgeon to visually inspect the uterus and feel for fibroids. It requires a short hospital stay and a recovery time of 4-6 weeks. Hysteroscopic myomectomy uses a tool called a resectoscope to enter through the vagina, release a liquid to expand the uterus and then shave away the fibroid pieces. Finally, laparoscopic myomectomy inserts a laparoscope, a small tube with a camera, into the pelvis and removes the fibroids through small incisions made in the abdomen. Laparoscopic patients are usually released the same day.
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A cystectomy is a surgical procedure used to remove part or all of the bladder for patients with bladder cancer. This procedure is performed under general anesthesia and requires a short hospital stay. During the procedure, an incision is made across the lower abdomen and the bladder, uterus, fallopian tubes, ovaries and part of the vagina are removed. This ensures that all traces of cancer are eradicated. A tube is created to collect the urine and the patient must wear a bag after surgery. Cystectomy is considered a safe procedure with a minimal risk of complications.
An oophorectomy is a surgical procedure used to remove one or both of the ovaries as a treatment for pelvic diseases such as ovarian cancer or severe endometriosis. This procedure is often performed with a hysterectomy, which removes the uterus; or with a salpingectomy, which removes the fallopian tubes. An oophorectomy can also be performed as a preventive procedure, as a prophylactic oophorectomy.
Women typically undergo this procedure as treatment for:
- Ovarian cancer
- Ovarian cysts or tumors
- Ovarian torsion (twisting of an ovary)
- Reducing the risk of ovarian and breast cancer
Some women have abnormal genes, known as BRCA1 and BRCA2 that give them an increased risk for developing ovarian cancer before the age of 70, many developing the disease around age 45.
This procedure may be performed through a traditional open incision or through laparoscopy with multiple small incisions, depending on each patient's individual condition. Most patients can return to fully activities within six weeks, sooner after laparoscopic surgery.
Some women who are at a higher risk for developing ovarian cancer or other pelvic disease may actually benefit from not undergoing an oophorectomy, so that they can avoid hormone problems, avoid an increased risk of fractures and osteoporosis and often enjoy a longer survival rate. Oophorectomy also increases a patient's risk of heart disease and does not completely eliminate the risk of ovarian or breast cancer.
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