A medical procedure which is performed by puncturing or cutting a patient's skin, or if an instrument is inserted into the patient, is considered invasive surgery. Minimally invasive surgery is performed by minimizing surgical incisions. When incisions are minimal, there is less trauma to the patient's body. Minimally invasive surgery is typically performed using an endoscope to guide the surgery and thin-needles visually.
Advances in Gynecologic Minimally Invasive Surgery
Minimally invasive surgeries such as hysteroscopy and laparoscopy are procedures done with less invasive techniques to treat gynecologic conditions. These types of surgeries typically require only a few small incisions, and in some cases, no incision. Minimally invasive surgeries are often performed on an outpatient basis for some treatments; other treatments will require a short hospital stay of one to two nights.
Minimally invasive surgeries have an essential role in general surgery as they are an alternative to traditional open surgery. Technological advancements and innovative procedures have seen these surgeries become more desirable to doctors and patients. Patients prefer this choice as a minimally invasive surgery that will leave them with better cosmetic results.
In healthcare, especially in minimally invasive surgery, innovation in the field has been described as dynamic and a continuous process to introduce new technology that changes in practice. These surgeries continue to improve and include technological innovations with the instruments used, sutures, surgical robots, image guidance systems, single-incision laparoscopic surgeries, and natural orifice transluminal endoscopic surgeries.
Since the 1980s, minimally invasive surgeries have shown a distinct pattern of growth. The first growth in this field was credited to novel surgical instruments and sutures that complement MIS (minimally invasive surgery). The second growth occurred when the concept of laparoscopic instruments were introduced, when these laparoscopic procedures were well established, new growth in the field occurred.
The second growth in MIS was largely in regards to image guidance and surgical robotics. These technologies, despite their complex engineering challenges, have continued to develop and keep up with clinical demands. Robotic technology continues to develop and has resulted in the third generation of surgical robots.
The most significant advancement of MIS in the last decade is primarily due to robotic surgery. Robotics was introduced in civilian hospitals, after mainly being used in the military environment to perform surgeries back in the 1970s. Now, combined with computer science, it is able to augment a surgeon's skills to achieve even greater precision and accuracy in complex surgeries.
All Women’s Care has the extensive expertise needed to perform these specialized techniques. Our doctors will take the time to sit with you and explain all the benefits to these surgeries and answer any questions you have before scheduling a procedure.
Advantages of Gynecologic Minimally Invasive Surgery
Minimally invasive surgeries offer techniques that are more effective alternatives and safer than traditional open surgery. The MIS (minimally invasive surgery) avoids having a large abdominal incision, which not only causes less trauma to your body; it also ends with a better cosmetic look. Advantages of gynecologic minimally invasive surgery include:
- Incisions are smaller
- There is less blood loss
- There is less pain
- Hospital stays are shorter
- Recovery times are faster so patients can return to daily activities sooner
- Scar tissue is reduced
- Risk of infection is less
Conditions Treated with Gynecologic Minimally Invasive Surgery
Gynecologic minimally invasive surgeries are used whenever it is possible over the open surgery. All Women's Care has the expertise needed in these techniques and treats a wide range of gynecologic conditions:
Endometriosis is a painful condition that happens when tissue in the lining of the uterus, known as the endometrium, grows outside of your uterus. Endometrial tissue can sometimes grow in other areas of the body, such as your pelvic area.
During a normal menstrual cycle, your ovaries produce hormones that make the uterine lining thicken in case there is a pregnancy. The lining breaks down and is shed during your menstrual period, along with other tissues and blood.
If you develop endometriosis, tissue much like the endometrial tissue grows outside of your uterus and will react to your ovaries hormones. These will grow and bleed during your period, but not exit your body. When the endometrial tissue develops on your ovaries, intestines, or bladder, it will build up over time in your pelvic area and result in severe pain along with other symptoms.
- Painful periods and heavy bleeding
In most women, menstrual cycles happen about every twenty-eight days and last from four to seven days. If you experience abnormal menstruation, such as heavy bleeding, irregular menstrual bleeding, or pain during your cycle, it is known as dysmenorrhea.
If these painful cycles cannot be controlled with over-the-counter medications, your doctor at All Women’s Care may suggest hormonal birth control to regulate your hormone levels or MIS (minimally invasive surgery.)
- Pelvic inflammatory disease
Pelvic inflammatory disease is a bacterial infection in your female reproductive organs. This disease is typically transmitted through sexual intercourse. Pelvic inflammatory disease does not generally have any symptoms, and you may not even realize you have it until you attempt to get pregnant. If symptoms do appear, they would include:
- Pain in the pelvis and lower abdomen
- An unpleasant odor with heavy vaginal discharge
- Irregular menstrual bleeding
- Pain during intercourse
- Pain in your lower back
- Vomiting, diarrhea, fatigue, and fever
- Difficult or painful urination
Standard treatments for pelvic inflammatory disease are typically antibiotics, along with over-the-counter pain relievers and bed rest. If these treatments do not relieve the condition, your doctor at All Women’s Care will discuss the option of MIS (minimally invasive surgery.)
- Pelvic scar tissue (painful adhesions)
A pelvic adhesion is a band of scar tissue that is binding two parts of your tissue that should not be joined together. Pelvic adhesions can involve any organ inside your pelvic areas such as the fallopian tubes, ovaries, uterus, or bladder. This condition is often the result of recent surgery.
Pelvic adhesions are often present along with other diseases such as irritable bowel syndrome or endometriosis. They can signal their presence by causing pain during sexual intercourse, but they are typically difficult to diagnose. A laparoscopic procedure or MIS can do treatment for these adhesions.
- Postmenopausal bleeding
There are a number of reasons for postmenopausal bleeding to occur. The most common cause is a thinning of the vaginal lining or womb lining and inflammation. These conditions are a result of estrogen levels decreasing, polyps in the womb, or cervix.
Women can experience a return of vaginal bleeding during the menopausal years. This bleeding can continue as spotting for a day or even a week, and when it goes away, it's natural not to think about it again.
If you have experienced a return of bleeding after menopause, you should consult your doctor at All Women's Care. It may be necessary to perform a biopsy of the lining in your uterus, or an ultrasound may be required to look at the thickness of the uterus lining. Early detection of cancer or abnormal cells increases your survival rate should the bleeding be related to a serious condition.
- Uterine polyps
Uterine polyps develop when the lining of your uterus overgrows in a particular area. Endometrial or uterine polyps grow from the wall of the uterus into the cavity and can range in size from that of a golf ball down to the size of a sesame seed. It not known exactly how or why these polyps develop, but factors that can increase their development include:
- Hypertension or high blood pressure
- Taking medication for breast cancer, tamoxifen
- Being Postmenopausal or perimenopausal
Not all women experience symptoms with uterine polyps, but when they are present, they include irregular cycles, bleeding in between cycles, heavier or longer cycles, bleeding after menopause, or infertility. Based on an evaluation by your doctor at All Women’s Care, treatment may include hormonal medications or MIS.
- Ectopic pregnancy
When an egg that has been fertilized implants and does not grow inside the main cavity of your uterus, it is called an ectopic pregnancy. The fertilized egg should attach to the lining of the uterus. A lot of ectopic pregnancies occur in the fallopian tube. The fallopian tube is what carries the egg from your ovaries to your uterus. These types of pregnancy can happen in other parts of your body, such as the abdominal cavity, the cervix, or in the ovaries.
If the fertilized egg grows in your fallopian tube, it will cause the tube to rupture. The inside of your abdomen will experience heavy bleeding, which is a life-threatening event and will be accompanied by lightheadedness, severe abdominal pain, shock, and fainting.
An ectopic pregnancy can be prevented from becoming a life-threatening event by treating them with methotrexate to stop the growth of the cells and dissolve existing cells. In some cases, this type of pregnancy is treated with laparoscopic surgery (MIS).
- Gynecologic cancer
Gynecologic cancer is a form of cancer that develops in a woman's reproductive organs. The different types of gynecologic cancers are named after the location where they begin:
If you are diagnosed with gynecologic cancer, you would be referred to a gynecologic oncologist who would determine which type of cancer you have and how to treat it. Many times if a surgical procedure is required, it is done as an MIS.
- Ovarian cysts
There are a number of cysts that can develop during the menstrual cycle. These are fluid-filled sacs that grow in your ovary, and some women are not even aware they have them. Most cysts are harmless and do not present any symptoms, but there are ovarian cysts that can be more serious and will become a serious problem if they become large and rupture.
If you have an ovarian cyst that presents symptoms, you may experience:
- Irregular menstrual cycle
- Pain in your pelvic area
- Pain when having a bowel movement
- Tenderness in your breasts, vomiting, and nausea
- Heaviness in your abdomen, a full filling, bloating
- Difficulty with urination or frequent urination
Your doctor at All Women’s Care will decide on the best treatment plan for you, should you be diagnosed with ovarian cysts. Depending on the symptoms you are experiencing, treatment could consist of birth control pills to reduce the development of new cysts, or minimally invasive surgery (MIS).
- Pelvic organ prolapse
Pelvic organ prolapse is when your pelvic organ gradually moves or drops to a lower portion of your pelvis. The bladder, rectum, or the top of the vagina are the main prolapsed organs. If you still have your uterus, it can also prolapse.
Pelvic organ prolapse happens when there is a weakness in your vagina wall, and this allows for other organs such as your rectum, bladder, or uterus to bulge into the vaginal canal. If this condition occurs, you will experience swelling pressure or heaviness in your pelvic area, pain in your lower back, loss of rectal or bladder control, or a hard time emptying your bowels.
There are a number of treatments for pelvic organ prolapse, and your doctor at All Women’s Care will carefully explain all options. One treatment is to use MIA to repair your native tissue. This procedure is performed transvaginally, without external incisions.
- Pelvic pain
Pelvic pain happens in the lowest portion of your pelvis or abdomen. It can be a sharp or dull pain or an intermittent or constant pain. This pain can be severe, mild, or moderate, and often radiates to your lower back or thighs.
Your doctor at All Women’s Care will complete a comprehensive evaluation and explain your diagnosis as well as treatment options. Depending on your specific case, your treatment could include:
- Nonsteroidal anti-inflammatory drugs
- Physical therapy
- Muscle relaxants
- Anti-inflammatory cortisone injections
- MIS (minimally invasive surgery)
- Uterine fibroids
Uterine fibroids are also called myomas and are noncancerous growths in or on the uterus. Uterine fibroids rarely develop into uterine cancer, but they can affect a woman’s quality of life. These fibroids range in size from a large mass weighing several pounds to microscopically small.
There is not an exact reason for why uterine fibroids develop, but genetic changes and hormones can affect their development. Not all these fibroids will present symptoms, but if they do, you can experience:
- Difficulty with bowel movements
- Iron deficiency anemia
- Frequent cycles or longer ones
- Painful sexual intercourse
- Pelvic pain, or a feeling of fullness
- Bleeding in between cycles
- Difficulty or frequent urination
- Dull aching pain in the lower back
- Blood clots during the menstrual cycle that will cause heavy and painful bleeding
Your doctor at All Women's Care will be able to offer treatment options for treating uterine fibroids. We will sit down and discuss the best treatment plan for your condition. Some prescription medications can help regulate menstrual cycles and relieve many symptoms, or you may need MIS to send sound waves into the fibroids to destroy the small area of tissue.
Types of MIS (Minimally Invasive Surgery) Available
Surgeons at All Women's Care work closely with each of our patients to determine what their individual symptoms are, their overall health, and any other factors to decide if they are good candidates for minimally invasive surgery (MIS). Depending on the individual conditions will determine which procedure is best suited for their needs, along with an evaluation of their overall health and symptoms being experienced. The different procedures or minimally invasive surgeries possible include:
- Vaginal technique
During a vaginal method, the surgeon makes a small incision in the vagina to reach the surgical site
- Robot-assisted laparoscopy
Gynecologic Robotic surgery is the latest innovation in MIS. This surgery uses a narrow, lighted scope along with miniature instruments that are controlled with a robotic system. Your doctor at All Women's Care can treat several conditions affecting a woman's reproductive organs.
A traditional, or open surgery, the surgeon would make one long incision to reach the treatment area. With the laparoscopic, or MIS, your doctor manipulates a scope and instruments through a few small incisions.
A robotic surgical system includes:
- A console where your doctor can control the instruments and scope by using hand controls. There is a screen on the console that your doctor uses to view the scope’s images
- A robotic cart that has arms, which can hold the instruments
- A camera that is able to provide 3D views of the surgical site
- Instruments that can translate the surgeon’s hand movements into precise micro-movements during surgery
Your doctor sits at the console and completes the most delicate, complex procedures by using small incisions with extreme precision. A robotic surgical system does not make movements on its own; it is not a programmable system.
Hysteroscopy is performed by the surgeon inserting a lighted, narrow camera, along with needed instruments through the cervix, to access the uterus. This procedure is completed without incisions.
Laparoscopy is much like a hysteroscopy, but instead of going through the uterus, it is done through the pelvic and abdominal cavities. Instead of using fluid to enlarge the cavity, carbon dioxide gas is used to provide visualization of your internal organs. A camera is placed on the laparoscope so the surgeon can guide it and document the findings with photos.
A laparoscopy procedure can be performed for many uses, including the treatment and diagnosis of endometriosis, fibroid tumors, chronic pelvic pain, ovarian cysts, and infertility.
- Laparoscopic-assisted vaginal technique
In a laparoscopic-assisted vaginal procedure, your surgeon accesses the surgical site using laparoscopy and the vaginal approach
- Single port surgery
During a single port surgery, your surgeon will perform laparoscopy with an incision into the belly button (navel).
By using MIA (minimally invasive surgery), your surgeon at All Women's Care is able to perform a significant range of procedures, including:
- Endometrial ablation
Endometrial ablation is a procedure to destroy the endometrium and reduce heavy bleeding during a woman’s menstrual cycle
A myomectomy is a procedure to remove uterine fibroids and rebuild the uterus
- Treatment and resection of endometriosis
Removes endometriotic implants and scar tissue along with restoring anatomy and the function of organs
- Cancer surgery
Removing cancer tumors from the ovaries, cervix, uterus, and other reproductive organs
- Tubal reanastomosis
This procedure will reverse a tubal ligation by reconnection of the fallopian tubes
- Cancer staging
Evaluation of cancer tissue in the attempt to determine whether it is late or early stage. This knowledge allows the doctor to schedule treatment plans.
With a hysterectomy, a woman’s uterus and in some cases the fallopian tubes and ovaries are removed
- Ovarian cystectomy
An ovarian cystectomy is a procedure to remove ovarian cysts
- Pelvic organ prolapse repair
Reattachment of suspension procedure to reposition prolapsed pelvic organs such as the rectum, or bladder back to its proper position
- Tubal ligation
Tubal ligation is a sterilization procedure where the fallopian tubes are blocked or cut to prevent pregnancy permanently
Minimally Invasive Gynecologic Surgeries and Why You Should Choose Them
Gynecologists who have been trained in minimally invasive surgery specialize in evaluating and treating women who have been diagnosed with noncancerous gynecologic conditions. Care is provided to you in either an exam room or inside an outpatient surgical suite. Minimally invasive gynecologic surgeries have been proven to be more convenient, reduce a patient’s discomfort, and are less expensive.
During a minimally invasive surgery, your surgeon will use small tools that are inserted through a small incision. A camera and microscope, along with tiny fiber-optic lights, send images on a high definition monitor so your surgeon can make smaller incisions. With smaller incisions, there are fewer scars and reduces your risk of developing an infection or clotting. Minimally invasive surgery also reduces your post-surgery pain and decreases your recovery time compared to traditional surgery.
Find Los Angeles Minimally Invasive Surgery Near Me
All Women's Care has made a lifetime mission to care for the needs of women. If you are having minimally invasive surgery for a diagnosed gynecology problem, talk to our doctors to discuss your options and find the best treatment possible for your needs. Call us today at 213-250-9461 and speak to our compassionate, dedicated, and expert doctors to find the best solution to your health needs.