Minimally Invasive Gynecologic Procedures

Your provider may recommend a hysterectomy – a procedure to remove your uterus –  to resolve or treat various conditions, including uterine cancer, fibroids, chronic pain or severe endometriosis.

Depending on your situation, the hysterectomy can be performed through the abdomen via an incision or through the vagina. Abdominal hysterectomies are more common when the surgeon removes the fallopian tubes and ovaries. Vaginal hysterectomies are more standard in cases of uterine prolapse.

In this procedure, sometimes referred to as a "D&C," your provider will dilate the lower part of the uterus and use special tools to clean the uterine lining and remove unwanted tissues. That helps prevent infection and remove fibroids or cancerous growths. This procedure may be performed by your ob-gyn after an abortion or miscarriage.

Endometriosis is a condition in which the cells of the uterine lining spread outside the uterus. Depending on the location of the endometriosis, it can cause severe pain and may reduce fertility. Endometriosis is sometimes treated with medication, while more serious cases involve laparoscopic surgery to remove the endometriosis growths.

A hysteroscopy is a minimally invasive surgical procedure that uses a tiny camera to inspect the inside of the uterus. It may be used to diagnose conditions or gain more information about symptoms like unexpected vaginal bleeding. A hysteroscopy may be performed instead of a D&C to remove growths like uterine fibroids.

Uterine artery embolization blocks the blood supply to the fibroid, causing it to die. The risk of complications after uterine artery embolization (UAE) is similar to other surgical methods. You can typically return to your normal activities after a couple of weeks, and your symptoms should improve. Your period may be interrupted but should gradually return to normal over a few months. 

The procedure is safe and generally effective, but fibroids can return after a UAE. About one-third of women who get a UAE will repeat the process within five years.

Your doctor may recommend a minimally invasive procedure to treat your fibroids. Sonata and Acessa use radiofrequency ablation (RFA) to apply heat to the fibroid, reducing its size and helping to relieve symptoms. 

Sonata uses a handpiece with a miniature high-resolution ultrasound tip that allows your doctor to see the fibroids from inside the uterus during the procedure. Each fibroid is then treated with ablation. Because the fibroids are treated from inside the uterus, there are no incisions.  

Acessa is completed laparoscopically – using small incisions in the abdomen – to insert a camera, ultrasound and handpiece. The handpiece is then used to target each fibroid with heat to reduce its size. 

RFA helps avoid traditional surgeries such as myomectomy and hysterectomy. In addition to quicker recovery, your surgeon is better able to target fibroids one by one, destroying them without harming healthy surrounding tissue. For women who want to preserve fertility, RFA avoids removal of the uterus through a hysterectomy. 

Roughly 25% of women will experience noncancerous growths in the uterus called fibroids. These growths can cause pain or bleeding and may interfere with other normal functions by blocking openings or applying pressure to other organs. Your surgeon can perform a minimally invasive laparoscopic treatment to remove these fibroids with minimal scarring and quicker recovery.

Minimally invasive surgery is also one method used to treat a type of urinary incontinence called "stress incontinence." The name refers to physical stress and occurs when unexpected actions like coughing squeeze your bladder and cause you to release urine. Some cases of stress incontinence can be treated without surgery through methods such as pelvic floor therapy.

In other cases, your physician may recommend other options, such as inserting a bladder sling. A bladder sling places a small amount of pressure on the urethra — the tube that urine exits through — and compresses it enough for you to regain control of your bladder. The sling can be placed using a minimally invasive procedure.