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Minimally invasive gynecologic surgery

Be assured that through our current training and technology, you will have the most updated approach to your upcoming procedure. Currently, I do most of my major cases at Hoag Hospital in Newport Beach—with state of the art equipment, well trained nurses, and outstanding anesthesiologists as well as subspecialist colleagues in general gynecology, general surgery, gyn-urology and gyn-oncology and reproductive endocrinologists and robotic options.

Hysterectomy

A hysterectomy is an operation to remove a woman's uterus. A woman may have a hysterectomy for different reasons, including:

  • Uterine fibroids that cause pain, bleeding, or other problems
  • Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal
  • Cancer of the uterus, cervix, or ovaries
  • Endometriosis
  • Abnormal vaginal bleeding
  • Chronic pelvic pain
  • Adenomyosis, or a thickening of the uterus

Hysterectomy is usually considered only after all other treatment approaches have been tried without success. This is very important in my practice—complications of surgery are rare, but a careful risk benefit analysis towards surgery is always warranted.

 Types of Hysterectomy

At this time in 2012----I am able to offer my patients about a 99% laparoscopic approach to hysterectomy with Same Day discharge-if the patient wants to go home the same afternoon and has someone to stay overnight with her. After 20 years of performing surgery through the open abdomen and watching women heal from large incisions and prolonged recovery,--it is quite exciting to able to have this state of the art approaches available for you! The recovery and healing are so much better than the “old days”. As you know, nothing is ever 100% in medicine—but we do our best to take good care of you.

Depending on the reason for the hysterectomy, a surgeon may choose to remove all or only part of the uterus. Patients and health care providers sometimes use these terms inexactly, so it is veryimportant to clarify if the cervix and/or ovaries are removed:

  • In a supracervical hysterectomy (LSCH), a surgeon removes only the upper part of the uterus, keeping the cervix in place. Gyn-urologists prefer this type to possibly support the bladder. However-you can still have menses if the cervix is left in place.
  • A total hysterectomy removes the whole uterus and cervix. Oncologists prefer us to use this approach removing most risk of cervical canter.
  • The ovaries may also be removed -- a procedure called oophorectomy -- or may be left in place. I will discuss your personal choices usually based on family history and age.

BRING US YOUR QUESTIONS AND ANY PREVIOUS TESTS AND MAYBE A FRIEND OR FAMILY MEMBER—let’s look at your options together.

 

© Copyright 2012, Mary J. Kotob, MD, FACOG. All rights reserved.
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