Minimally Invasive Gynecologic Surgery

 

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A Collaborative, Patient-Centered Philosophy

The arc of a woman’s life is marked by profound physiological changes from puberty to menopause. From time to time, these changes require expertise beyond routine gynecologic care.

At The GW Medical Faculty Associates, our gynecologic specialists have advanced training in Minimally Invasive Gynecologic Surgery. They are high volume surgeons focusing solely on advanced surgical techniques to manage complex gynecologic conditions. Our surgeons pursue a team-based approach to care — coordinating with specialists from urology, fertility and colorectal surgery to ensure patient concerns are heard, understood, and treated appropriately.

We begin with a careful assessment conducted in our offices supported by diagnostic technologies such as:

• bedside ultrasound
• flexible and rigid hysteroscopy including polypectomy 
• saline-infusion ultrasonography
• endometrial sampling 

When surgery is recommended, our doctors are dedicated to pursuing the advantages offered through minimally invasive gynecologic surgery. That approach commonly results in reduced pain, speedier recovery, and briefer hospital stays — when hospitalization is warranted at all. A majority of our patients are treated by laparoscopy or hysteroscopy.

Surgical Approaches

Advanced Laparoscopy

Laparoscopy is the use of small punctures in the abdomen to perform a surgery rather than a large, open incision. This allows procedures to be done with less complications, a same-day discharge, and a faster recovery. Almost every patient is a candidate for laparoscopy and we encourage patients to seek us out for second opinions if they have been told otherwise. Every surgery is customized to each patient's anatomy.

Advanced Robotic Surgery

Robotic surgery can enhance precision and an excellent tool for complex surgeries such as advanced endometriosis and patient with history of multiple surgeries.  We have been pioneers in pushing the envelope of robotic surgery and are nationally recognized for our skill and efficiency in this modality of laparoscopy.

Complex Hysteroscopy 

We have experience in performing hysteroscopy with difficult pathology such as large fibroids, Asherman’s syndrome, and uterine anomalies. We utilize both the resectoscope and MyoSure device that tailors to the disorder we encounter. 
 

Our Services

Endometriosis Excision

Endometriosis is a painful and chronic disease of pre-menopausal women. Extensive disease, scarring, and pain can prompt a series of surgeries and compromised quality of life. Our gynecologic surgeons have the expertise to manage the most complex cases, including involvement of the bowel, bladder, and extra pelvic endometriosis. They use a multidisciplinary approach collaborating with specialties such as colorectal surgery, urology, thoracic surgery, pelvic floor physical therapy, and chronic pain specialists.

Myomectomy

There is no single recommended approach to dealing with uterine fibroids. When medications have failed to resolve a woman’s heavy or prolonged periods, pain, urinary incontinence or constipation, she may be a candidate for myomectomy. A thorough exam using flexible hysteroscopy, saline infusion sonography or MRI will helps establish an appropriate plan.

Most myomectomies can be performed minimally invasively using hysteroscopic, laparoscopic, robotic, and mini-laparotomic techniques.

Our surgeons are nationally recognized for their expertise in laparoscopic suturing. They understand the importance of careful uterine repair to help ensure a successful pregnancy after treatment.

Hysterectomy

A majority of patients are treated either laparoscopically or vaginally. Laparoscopic removal of even the largest uterus is completed by blending vaginal surgery, robot assisted laparoscopy, and more common two-to four-incision laparoscopy.

Alternatives to Hysterectomy

No two patients are the same. Our physicians emphasize exploring all reasonable conservative options to manage symptoms — including hormone treatments to control bleeding and pain, progesterone IUDs, fertility sparing endometriosis excision, and myomectomy.

Chronic Pelvic Pain

It is estimated that 15-20% of female patients in their reproductive age suffer from chronic pelvic pain. Many are a result of complex gynecologic disorders such as endometriosis, adenomyosis or large fibroids, or often undiagnosed pelvic floor dysfunction or neuropathic etiologies. We work in a multidisciplinary fashion, with Sexual Health, Pelvic Floor Physical Therapy, Urogynecology, to provide trauma-informed medical and surgical care to the patients deeply affected by this condition. 

Why Choose Our Team

Expertise. Our physicians are leaders in the use of the advanced techniques. When conservative treatments have failed to deliver the desired results and surgery is recommended, our surgeons offer minimally invasive surgery, performed through an incision in the vagina or through small abdominal incisions or even a single incision hidden in the belly button. Some patients may be candidates for robotic surgery.

Experience. Our gynecologic surgeons are subspecialty trained and perform hundreds of procedures every year, including robotic hysterectomies.

Collaborative approach. Multispecialty teams draw from expertise in gynecology, urology, fertility and colorectal specialties to determine appropriate approaches to treatment.

 

AAGL CENTER OF EXCELLENCE AWARD