Surgicial procedures

The DaVinci Robot has revolutionized Women's Healthcare.  If Hysterectomy is needed, no longer are women subjected to a large abdominal incision and long recovery of their Grandmothers.  With 4 dime sized abdominal incisions, a hysterectomy can be performed, complete or partial, leaving either the ovaries or cervix.  About half the patients go home the same day.

Vaginal Hysterectomy allows the patient to avoid any abdominal incision..  This route requires the cervix and uterus at minimum to be removed.  Ovaries are optional.

The DaVinci Robot allows extremely precise and delicate surgical technique that is not possible by the human hand.  For women not receiving acceptable management of their endometriosis from medications then conservative surgical resection of endometriosis is an excellent option.  The DaVinci Robot has the option of infrared illumination which allows improved visualization and resection of endometriosis implants.

Almost half of women will develop fibroids,  if they develop before childbearing is complete the Davinci Robot is an excellent option to remove fibroids and preserve fertility.

For women with family history of gynecologic cancers or who carry genetic mutations that increase their risk of cancer, risk reducing surgery by removing the ovaries and fallopian tubes can be performed 

For women who have completed childbearing and would like a reduction or elimination of their menstrual flow, an ablation is an option.  This is an outpatient 30 minute procedure performed while the patient is asleep under visualization.  No cutting or stitching is involved.  The majority of patients have no more periods with the rest having only light peroids or spotting.

Pap smears test for the presence of the HPV (Human Papilloma Virus).  If the HPV has caused abnormal cells to develop on the cervix (Dysplasia) they can be removed by a procedure called a LEEP conization (Large Electrical Excision Procedure).  This is done outpatient under local anesthesia and takes about 15 minutes

Vaginal childbirth can weaken the pelvic floor.  Sometimes the front of the vagina falls (the bladder) sometimes the back wall of the vagina falls (the rectum) sometimes the uterus falls (uterine prolapse) or sometimes a combination of all three.  The prolapse of the bladder and rectum can be repaired with an outpatient procedure with the patient asleep and takes about an hour.  I use dissovable stitches so there are no concerns about synthetic mesh eroding through the tissues later in life.  This will also help improve any urinary incontinence or difficulties with bowel movements associated with the prolapse.

Some women develop hypertrophy (enlargement)of the labia.  This can cause physical and psychological distress.  An outpatient procedure while asleep can correct the anatomy of the labia and vagina

Dilation and Curettage (D&C) can be used to improve heavy periods and is usually combined with an ablation for long term treatment of heavy periods if childbearing is complete.  D&C's alone are usually performed when a miscarriage is diagnosed to safely removed the placental tissue to stop bleeding.

For women with uterine prolapse (pelvic floor hernia) a sacrocolpopexy is the treatment of choice.  This is an overnight stay outpatient procedure done robotically.  I first perform and partial hysterectomy leaving the cervix.   Another surgeon then comes in to attach the remaining cervix to the sacral bone resuspending the pelvic floor