Are you facing a condition that may require surgery? In doing your research, you will come across many methods of performing the same procedure. Also, you will come across different treatments for the same disease. This can be very confusing. We at Capital Women's Care Division 24 will help guide you through this process. We pride ourselves on being experienced in many different and surgical treatment options for common gynecological conditions. We are all Board Certified physicians and are highly experienced in performing many different surgical procedures, most of which follow a minimally invasive approach. The following is a list of some of our surgical services.
Minimally Invasive Surgery
Minimally Invasive Surgery (MIS) is commonly called "belly button surgery." These are surgical techniques that decrease the length of the incision or avoid an incision altogether. This generally results in less pain, faster recovery, lower risk of infection and a quicker return to normal function. At our practice, we pride ourselves in providing the most up-to-date and advanced surgical procedures, including vaginal surgery, hysteroscopy, laparoscopy and robotic surgery. The following are examples of MIS procedures:
Hysteroscopy is a type of MIS where the inside of the uterus (endometrial cavity) is visualized using a camera (hysteroscope) that is inserted through the natural opening of the cervix. No incision is made. This can be used for diagnosing endometrial problems, as well as for treating uterine adhesions, uterine septums and removing endometrial polyps and some fibroids. It is an outpatient surgery with most patients going home the same day and being back to work within 48 hours.
A. Endometrial Ablation
Abnormal and heavy bleeding is a very common challenge that many women face. Traditionally, if hormones were unable to improve the symptoms, a hysterectomy was the only option. We now have a very effective minimally invasive treatment option called endometrial ablation. During endometrial ablation, the cavity of the uterus is cauterized using a sophisticated technology that allow for individual treatment. There are several different ways of performing an endometrial ablation. If you have heavy periods, talk to the doctors at Capital Women's Care Division 24 to see if endometrial ablation is the right procedure for you. It is a minimally invasive and same day procedure with most patients going home the same day and being back at work within 48 hours.
B. Hysteroscopic Tubal Occlusion
Tubal occlusion is another option for permanent birth control. This is a procedure that is done hysteroscopically. A narrow camera (hysteroscope) is inserted into the uterus and the opening of both tubes are visualized by the surgeon. Using the Essure device, small inserts are placed into the tubes, resulting in blockage from the inside. The procedure is approximately 10 minutes, and most women are able to return to work the next day. A simple test called a hysterosalpingogram is done three months later to ensure the procedure has been successful.
Laparoscopy is also called "belly button surgery." It refers to several small incisions (1/2-inch to 1-inch long) that are made in the lower abdomen. Through these incisions, instruments are placed into the abdomen to perform the surgery. Below are some types of laparoscopic procedures performed by the physicians at Capital Women's Care Division 24:
A. Bilateral Tubal Ligation
The laparoscopic approach is very commonly used to provide permanent birth control. Using 1-2 small incisions and a laparoscopic technique, both tubes can be either cauterized or have small clips applied. This results in immediate and effective permanent birth control It is done as an outpatient procedure, and women can usually return to work within several days.
B. Laparoscopic Ovarian Cystectomy
Ovarian cysts are very common. Fortunately, many of them are a normal part of ovarian function and usually resolve on their own. Sometimes, however, they require surgery. A laparoscopic approach can usually be used, with complete removal of the cyst allowing for the normal part of the ovary to be preserved. Most women are able to have this done as an outpatient procedure and can usually return to work several days later.
Myomectomy refers to the surgical removal of uterine fibroids. Fibroids are growths of muscle that can cause heavy menstrual cycles, painful menstrual cycles and pain during intercourse. Fibroids may also result in infertility and pelvic pain. There are many ways to treat uterine fibroids, including medical and surgical methods. Below are the surgical methods provided by the physicians at Capital Women's Care:
A. Laparoscopic Myomectomy
In this procedure, small incisions, about 1/2-to-1-inch long, are made in the abdomen. Through these small incisions, a camera (laparoscope) is inserted to visualize the fibroids. The fibroids can then be removed through the laparoscope. This is usually an outpatient procedure with full recovery in as little as a few days.
B. Hysteroscopic Myomectomy
In this procedure, a small camera is inserted through the vagina into the uterus to remove fibroids that are within the cavity of the uterus. No incisions are made in the abdomen or in the vagina. This is usually an outpatient procedure, with full recovery in as little as a few days.
Hysterectomy refers to the surgical removal of the uterus. There are several ways of performing a hysterectomy, and the doctors at Capital Women's Care Division 24 perform all of them. If you have a condition and are facing a hysterectomy, contact one of our doctors to see which method is best for you.
A. Total Vaginal Hysterectomy (TVH)
TVH is a hysterectomy that is performed via a vaginal approach. It is the least invasive of all types of hysterectomy. In this procedure, the cervix and uterus are removed. There are no abdominal incisions. Recovery usually includes one night in the hospital and return to work is often as short as three to four weeks.
B. Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
Laparoscopic Assisted Vaginal Hysterectomy is a type of "belly button surgery." Small incisions, about 1/2-inch to 1-inch, are made in the abdomen. Instruments are placed into the abdomen through these small incisions and the first portion of the hysterectomy is performed through these incisions. The uterus and cervix are then removed through the vagina. This procedure usually takes two hours and most patients stay one night in the hospital and are home the next day. Most patients are back to their usual function within three to four weeks.
C. Laparoscopic Supracervical Hysterectomy (LSH)
LSH is a type of hysterectomy that is done completely through the laparoscope. The body of the uterus is removed, not the cervix. This procedure takes approximately two hours and most patients stay one night in the hospital and are home the next day. Return to work is often as soon as three to four weeks.
D. Total Laparoscopic Hysterectomy (TLH)
TLH is a type of hysterectomy done completely through the laparoscope. In this procedure, the entire uterus and cervix are removed. This procedure takes approximately two hours and most patients stay one night in the hospital and are home the next day. Removing the cervix eliminates the risk of cervical cancer, and also ensures that there will not be monthly bleeding from the cervix, which can occur after 2 to 3-percent of patients who have undergone a LSH. The decision to have a LSH versus a TLH is a personal on that can be discussed with your surgeon.
E. Da VInci Robotic Hysterectomy
Any of the above types of hysterectomy can be performed using the da Vinci Robotic System. This system is an advancement in laparoscopic surgery. Robotic surgery combines superior 3D, high definition vision, patented EndoWrist instruments and intuitive motion to allow for improved precision, visualization, dexterity and control. Using the da Vinci Surgical robot, surgeons are capable of performing very complex and challenging surgeries using minimally invasive techniques. We are pleased to have one of the most experienced da Vinci surgeons in the area, Dr. David Wagar, to provide this important technique.
Pelvic Organ Prolapse
Pelvic organ prolapse refers to the "falling down" of the pelvic organs, such as the bladder, uterus and/or rectum. This is a very common occurrence, especially after vaginal childbirth and menopause. Most patients report a sensation of "pressure" in the vaginal area or a "bulge" in the vaginal area. Some patients also report leakage of urine, especially with coughing or sneezing. POP can be treated in various ways, depending on the severity of the prolapse and the impact on the patient's lifestyle. The physicians at Capital Women's Care pride ourselves on our ability to diagnose and treat the various types of pelvic organ prolapse.
A cystocele is the "dropping" of the bladder into the vagina. It is one of the most common types of pelvic organ prolapse. Cystocele can be treated with conservative measures such as a pessary or via surgical methods such as an anterior colporrhaphy.
B. Uterine Prolapse
Uterine prolapse refers to the "dropping" of the uterus into the vagina. It is also one of the most common types of pelvic organ prolapse. Uterine prolapse can be treated with conservative measures, such as a pessary or via surgical methods such as a vaginal hysterectomy.
A rectocele is the "dropping" of the rectum into the vagina. It can be treated with conservative measures such as a pessary or via surgical methods such as a posterior colporrhapy.
Urinary Incontinence is one of the most common problems that women will face. There are several types of urinary incontinence—stress, urge, mixed and overflow. We are pleased to provide a diagnostic test called Urodynamics to determine which type(s) of urinary incontinence is/are present. We can tailor your treatment according to the results of this test.
A. Trans Vaginal Tape (TVT)
The TVT is a revolutionary method to treat stress urinary incontinence. It involves the placement of a narrow "tape" under the urethra (the tube that carries urine from the bladder to the outside). This tape is placed free of tension. Following placement of the TVT, a cystoscopy procedure (placing a camera into the bladder) is performed. The entire procedure takes about 45 minutes to perform. Most patients are home the same day and can resume normal bladder function after the procedure. The TVT is a highly effective procedure, which can truly allow women to resume their normal daily activities.