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Common Procedures

Following an appointment with a gynecologist, it is possible that some women may need a procedure to maintain their health. In this case, women can visit the Department of Obstetrics and Gynecology, which has been named a Center of Excellence in Minimally Invasive Gynecology by the American Association of Gynecologic Laparoscopists (AAGL), the largest minimally invasive gynecologic professional organization in the world. The designation is awarded to facilities and surgeons that have met AAGL’s requirements for delivering high-quality perioperative patient care and are dedicated to offering women minimally invasive surgery whenever possible. The following is a list of common minimally invasive obstetric and gynecological procedures performed at BMC:

Hysterectomy 
A hysterectomy is a procedure to remove the uterus. It is a very common type of surgery for women in the United States. Removing your uterus means that you can no longer become pregnant. Different types of hysterectomies include:

Total Laparoscopic Hysterectomy (TLH)
TLH is the removal of the uterus and cervix through four small abdominal incisions. Depending on the patient’s individual case, the ovaries and fallopian tubes may also be removed.

Laparoscopic Supracervical Hysterectomy (LSH)
This procedure involves laparoscopic removal of the uterus and the patient is able to keep her cervix. The patient can either keep her ovaries or have them removed at the same time. 

Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
LAVH is a surgical procedure using a laparoscope to guide the removal of the uterus and/or fallopian tubes and ovaries through the vagina.

Fibroid Removal
Fibroids are noncancerous tumors in the muscle of the uterus. Treatment approaches for removing fibroids includes:

Laparoscopic Myomectomy for Fibroids
This surgery involves removing fibroids (noncancerous tumors in the muscle of the uterus) from the wall of the uterus.

Hysteroscopic Myomectomy
Hysteroscopic myomectomy involves inserting a thin lighted viewing instrument (hysteroscope) through the vagina and the cervix into the uterus. This instrument then allows the doctor to view the fibroid to remove it through the vagina.

Ovarian Cyst Removal
An ovarian cyst is a fluid-filled sac that develops on a woman's ovary. Patients who need a cyst removed may receive the following minimally invasive treatment:

Laparoscopic Ovarian Cystectomy
Laparoscopic Ovarian Cystectomy is surgery to remove a cyst or cysts from one or both of the ovaries using small incisions and specialized tools. 

Treating Adhesions
Adhesions are scars that form within the body, typically after surgery, as part of the healing process.

Laparoscopic Lysis of Adhesions
This procedure is used to treat abdominal and chronic pelvic pain caused by adhesions. 

Diagnostic Hysteroscopy
A diagnostic hysteroscopy is a gynecologic procedure to evaluate the endometrial cavity, the layer of mucus membranes that line the uterus.

Removing Uterine Polyps
Uterine polyps are noncancerous cells that grow on the inner wall of the uterus and extend to the uterine cavity

Hysteroscopic Polypectomy
Hysteroscopic polypectomy is a surgery to remove uterine polyps. This allows the uterus to be preserved. 

Hysteroscopic Endometrial Ablation
A thin lighted viewing instrument (hysteroscope) is used to see inside the uterus. Then, to treat abnormal uterine bleeding, an endometrial ablation procedure is performed and destroys (ablates) the uterine lining.

Hysteroscopic Sterilization (Essure)
Hysteroscopic sterilization is a type of tubal sterilization procedure that uses the body's natural openings to place small implants into the fallopian tubes. These implants cause tissue growth that blocks the tubes. No surgical incision is needed.

Robotic-Assisted Surgery
In robotic-assisted surgery, the surgeon uses a computer-controlled device that moves, positions, and manipulates surgical tools based on his or her movements. He or she sits at the computer console with a monitor and the camera provides a three-dimensional view of the surgical area that is magnified 10 times greater than a person's normal vision. The surgeon's hands control the robotic arms to perform the procedure.

Robotic-assisted surgery is performed to treat pelvic organ prolapse, fibroids, and gynecological cancers in appropriately selected patients.
Patient benefits may include:

  • Reduced body trauma and pain
  • Reduced blood loss and/or need for blood transfusions
  • Reduced post-operative pain and/or discomfort
  • Reduced hospital stay

The daVinci Robotic Surgical System allows surgeons to perform complex minimally invasive procedures using a set of small incisions rather than a large incision. A laparoscopic sacrocolpopexy or myomectomy that, in the past, required a standard incision can now be performed with minor incisions, greatly improving recovery time and patient comfort.

With the 3-D stereoscopic view provided by the daVinci Surgical System, surgeons can more easily identify vital anatomy while performing precise surgical dissections, and removing specific tissues. The robot's EndoWrist Instruments provide surgeons with enhanced dexterity that is not always available using conventional laparoscopic or open procedure instruments. The daVinci Surgical System allows for a minimally invasive alternative surgical procedure to open gynecologic surgery. The daVinci Surgical System is the first operative surgical robot deemed safe and effective by the United States Food and Drug Administration for performing robotic surgery.

For further information or to schedule a consultation, please contact the OB/GYN Call Center at 617.414.2000.
 

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