Myolysis (myoma drilling, myoma coagulation) is a procedure whereby fibroid tumors are drilled multiple times with laser or electrocautery. This destroys the blood supply to the tumors, causing them to shrink 40% to 60% in size. The tumors remain, however, they are considerably smaller. The procedure is performed via laparoscopy in an outpatient surgical center. Patients are able to return to work in 2 to 3 days.
Cystectomy refers to the removal of a cyst (fluid-filled sac found on the ovary), leaving the normal ovarian tissue in place. Some patients with ovarian cysts require surgery to remove the mass itself or the entire ovary. In general, this is reserved for patients with large, persistent growths, or when the growth is causing symptoms. Oophorectomy refers to the removal of the ovary. Ovarian cystectomy is generally performed via laparoscopy in an outpatient surgical setting and the patient can generally return to work in 2 to 3 days.
This procedure is used to diagnosis and treat problems related to the inside of the uterine cavity. The procedure is performed in the office or outpatient surgical center wherein a telescope-like instrument (hysteroscope) is inserted through the vagina and into uterus cavity to diagnosis and treat abnormal growths known as polyps that may cause heavy bleeding, fibroid tumors, scar tissue, and other problems.
Endometrial Cryo Ablation
This procedure is performed in the office or an outpatient surgical center primarily for menorrhagia (heavy periods). It incorporates the destruction of the lining of the uterine cavity and can be rendered via hysteroscopy with the use of laser or electrocautery, or with instruments designed to freeze or burn the lining. Small fibroid tumors can also be destroyed with this procedure. However, women who desire future pregnancy should not receive endometrial ablation. Outpatient "Her Option" cryoablation is our main ablative technology.
Uterosacral ablation is performed via laparoscopy in an outpatient surgical center usually for pelvic pain or symptoms consistent with endometriosis. The ligaments that are attached to the uterus contain nerves that are treated with laser or electrocautery in order to decrease or eliminate pelvic pain. It does not interfere with future pregnancy. Patients can usually return to work in 2 to 3 days.
Presacral neurectomy is performed in an outpatient surgical setting via laparoscopy for patients with severe pelvic pain. These patients usually have a long history of pelvic pain secondary to endometriosis and have tried numerous medications and surgical procedures to decrease their pain without success. The presacral pelvic nerves are divided with laser or electrocautery, thereby decreasing or eliminating pelvic pain. This procedure does not interfere with future pregnancy and patients may return to work in 2 to 3 days.
Hysterectomy is the removal of the uterus, which is the organ that babies are housed and protected in until birth. Hysterectomy can involve removing the entire uterus (total hysterectomy) or leaving behind the cervix (supra cervical hysterectomy). The procedures can be performed via laparoscopy, mini-laparotomy, laparotomy, or via the vagina. Most procedures can be performed via laparoscopy or mini-laparotomy, thereby allowing the patient to be discharged in 1 to 2 days from the hospital. This procedure, as others, should be individualized for each patient. Our gynecologist doesn't perform a great number of hysterectomies because most of the problems that patients encounter can be taken care of without taking out the uterus.
Labial & Vulvar Reshaping
Many women feel dissatisfied with the appearance of their external genitals. Some also complain of discomfort in that area during exercise or walking. Dissatisfaction with the external anatomy can cause difficulties with intimacy and self-image. The size of the labia can increase due to hypertrophy or thickening of the skin. Procedures such as labial and clitoral tissue reduction and introitoplasty are designed to help improve anatomical appearance and sexual comfort. This can be an embarrassing topic for many women. If you feel that you may benefit from surgical revision, we encourage you to express your concerns freely so that we can carefully discuss your treatment options.
Tuboplasty is the revision or repair of the fallopian tubes for infertility problems. The procedure is generally performed via laparoscopy to assist with pregnancy in women who have a tubal factor condition related to one of the reasons why she is not able to get pregnant. Fallopian tubes can be damaged or blocked by a number of disorders, such as pelvic inflammatory disease (PID) related to STDs, previous surgery, endometriosis, post-partum infections, or a combination thereof. The laparoscopy treatment involves alleviating adhesions and opening up the ends of the tubes. Occasionally, this procedure may be performed via laparotomy. When performed via laparoscopy or laparotomy, it's done in an outpatient surgical center and the patients can generally return to work in 2 to 3 days.
Tubal sterilization is a very common procedure wherein a portion of the fallopian tube is blocked by burning, tying, cutting and tying, or placement of a ring or band on the tubes. It can be performed right after delivery of a child or via laparoscopy as an outpatient procedure. If the tubes are not badly damaged or a significant portion of the tubes isn't destroyed by the sterilization procedure, a tubal reversal may be performed to assist with pregnancy.
Patients who desire tubal reversal should obtain their operative note from the sterilization surgery and the pathology report if available. This will assist in determining the type of procedure that was performed and whether the tubal reversal can be administered. The operative note and pathology report should be sent to our office prior to the initial consultation if possible. In addition, a semen analysis is recommended for the husband after your consultation.
The surgeon's fee for tubal reversal varies from $4,100 to $6,100 and is not covered by insurance. The exact amount of the fee is presented after your initial evaluation and varies relevant to your size, weight, previous major abdominal surgeries, medical condition, and projection of type of tubal repair needed. The outpatient hospital costs, such as anesthesia, are separate and not included in the surgeon's fee.
The tubal reversal procedure is performed in an outpatient hospital setting under general anesthesia and may take 3 to 31/2 hours to perform. Laparoscopy is the insertion of a telescope like device (laparoscope) into the abdomen via an incision in the navel to visualize the pelvis and its contents. This procedure is performed immediately prior to the tubal reversal. Laparoscopy allows our gynecologist to directly evaluate the condition of the tubes and other pelvic organs. The procedure is videotaped and photos are obtained. If the tubes are able to be put back together, a small 2" to 3" incision is placed in the pubic area and the tubal reversal is initiated. Once the procedure is completed, photos of the repaired tubes are obtained. After completion of the procedure, the patient is discharged the same day and is generally able to go back to work in a few days. The couple must refrain from intercourse for 4 weeks to allow the tubes to heal. Photos of the procedure are given to the patient at the first post-op visit. It is extremely important for the patient to be evaluated after the procedure as prescribed and once pregnancy is attempted to be evaluated if the menses are missed for possible pregnancy.