Uterine Procedures

At Complete Women Care, we dedicate an entire team to assist you throughout the process of your uterine procedure

What are the surgical procedures pertaining to the uterus?

Myomectomy

Can fibroids be removed without removing the uterus?

A myomectomy is a uterine procedure involving an operation to remove fibroids while preserving the uterus.  These common non-cancerous growths appear in the uterus, usually during childbearing years, but they can occur at any age. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best uterine treatment option. A myomectomy can be performed in several different ways. Depending on the size, number, and location of your fibroids, you may be eligible for other uterine procedures such as;  abdominal myomectomy, a laparoscopic myomectomy, or a hysteroscopic myomectomy. The surgeon’s goal during myomectomy is to take out symptom-causing fibroids and reconstruct the uterus. 

What is an abdominal myomectomy?

Also known as an “open” myomectomy, an abdominal myomectomy is a major surgical procedure.

During this uterine procedure, an incision is made on the lower abdomen (a “bikini cut”). The fibroids are removed from the wall of the uterus, and the uterine muscle is sewn back together using several layers of stitches 

Is laparoscopic myomectomy major surgery?

A myomectomy is defined as a uterine procedure to remove fibroids (noncancerous lumps) from the uterus. Any surgery is called a major surgery if it requires overnight or extended stay in the hospital needs anesthesia and involves removing or altering a part of the body. So, a laparoscopic myomectomy can be considered major surgery.

In a laparoscopic myomectomy, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes, and uterus. Long instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is then sewn back together, the gas is released and the skin incisions are closed. At the Complete Care Surgical Center we offer 3D laparoscopic technology which allows us to perform the uterine procedure with one incision in the belly button. 

How is a hysteroscopic myomectomy performed?

Only women with submucosal fibroids — fibroids that expand from the uterine wall into the uterine cavity — are eligible for this type of myomectomy. During the uterine procedure, the woman, most likely under anesthesia, is on her back with feet in gynecology stirrups. A speculum is placed in the vagina and a long, slender telescope is placed through the cervix into the uterine cavity. The uterine cavity is filled with fluid to lift apart from the walls of the uterus. Instruments passed through the hysteroscope are used to shave off the submucosal fibroids. 

Removal of Uterine / Endometrial Polyps

How do they remove polyps from uterus without disturbing the rest of the endometrium?

The best way to remove endometrial polyps is to perform a hysteroscopy. An anesthetic is used to eliminate discomfort. During the uterine procedure, a small scope is inserted into the intrauterine cavity which allows the doctor to see the inside of the uterus. With direct visualization, the polyp can be removed without damaging the rest of the endometrium. 

What are uterine polyps?

Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign). 

What are the symptoms of uterine  polyps?

Polyps often have no symptoms. When symptoms do occur, they include irregular or excessive menstrual bleeding, bleeding between menstrual periods, or bleeding after menopause

Diagnosis of uterine polyps

Uterine polyps can be diagnosed with the help of: 

Transvaginal Ultrasound – A slender, wand-like device placed in your vagina emits sound waves and creates an image of your uterus, including its interior. Your doctor may see a polyp that’s clearly present or may identify a uterine polyp as an area of thickened endometrial tissue. 
Hysterosonography – Involves having salt water (saline) injected into your uterus through a small tube threaded through your vagina and cervix. The saline expands your uterine cavity, which gives the doctor a clearer view of the inside of your uterus during the ultrasound. 
Hysteroscopy – The doctor inserts a thin, flexible, lighted telescope (hysteroscope) through your vagina and cervix into your uterus. A hysteroscopy allows the doctor to examine the inside of your uterus. 
Endometrial biopsy – The doctor might use a suction catheter inside the uterus to collect a specimen for lab testing. Uterine polyps may be confirmed by an endometrial biopsy, but the biopsy could also miss the polyp. 

Dilation and Curettage

What is a D & C?

A dilation and curettage uterine procedure also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues. A suction D&C uses suction to remove uterine contents. A sample of uterine tissue is also taken and viewed under a microscope to check for abnormal cells. The procedure can be either operative or diagnostic. 

Why is a D & C done? 

D&C is usually done to remove tissue in the uterus during or after a miscarriage or abortion or to remove small pieces of placenta after childbirth (This helps prevent infection or heavy bleeding) and also to diagnose or treat abnormal uterine bleeding. D&C can be a treatment for fibroids, polyps, Endometriosis, Hormonal imbalances, and uterine cancer. 

Hysteroscopy 

What is a hysteroscopy?

A hysteroscopy is a uterine procedure that allows your provider to look inside the uterus in order to diagnose and treat the causes of abnormal bleeding. Hysteroscopies are done using a hysteroscope – a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative. 

Diagnostic hysteroscopy 

This uterine procedure is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm the results of other tests, such as hysterosalpingography (HSG). An HSG test uses an X-ray dye to check the uterus and Fallopian tubes. Often, diagnostic tests can be done in an office setting without need for full sedation. 

Is operative hysteroscopy major surgery?

Operative hysteroscopy is a minimally invasive gynecological procedure used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope. 

Our surgeons may perform hysteroscopies to treat polyps and fibroids, adhesions, septums, and abnormal bleeding. 

What is a Laparoscopic Uterine Nerve Ablation (LUNA) procedure?

Laparoscopic Uterine Nerve Ablation, or LUNA, involves the destruction of the uterine nerve fibers that exit the uterus through the uterosacral ligament (this ligament connects the uterus to the large bone at the base of the spine). During this uterine procedure, the abdomen cavity is inflated with carbon dioxide gas and small incisions are made in the abdomen to provide access for the laparoscope and surgical instruments. The uterus is anteverted (inclined forward toward the front of the abdomen) with a uterine manipulator and the uterosacral ligaments are identified and transected close to their attachment to the cervix. One or both of the ligaments may be transacted. LUNA is often carried out during the course of other surgical treatments for endometriosis and to treat chronic pelvic pain. 

Is Hysterectomy (uterus removal) a major surgery?

Hysterectomy is a major surgical procedure in which the uterus is removed. Many women choose hysterectomy to definitively resolve their fibroid symptoms. After a hysterectomy, menstrual bleeding stops, pelvic pressure is relieved, frequent urination improves and new fibroids cannot grow. Hysterectomies at the Complete Care Surgical Center are performed laparoscopically either by using the common laparoscopic approach with 4 incisions or by using our one incision 3D technology. During this uterine procedure, the abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the surgeon can see the ovaries, fallopian tubes, and uterus. Long instruments, inserted through the incision/incisions are used to remove the uterus. A special instrument is used to cut the uterus into smaller segments for removal through the small incisions. At the end of the procedure, the gas is released and the skin incision/incisions are closed. 

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