The Chester County Hospital gynecologic team provides services in all areas of gynecological surgery, including adult and adolescent gynecology, oncology, urogynecology and pelvic reconstructive surgery, and infertility surgery. The majority of gynecologic surgery is performed on an outpatient basis, using minimally invasive procedures that allow for immediate recovery at home and a quick return to normal activities.
Minimally Invasive Surgeries
Minimally invasive surgery has revolutionized the field of surgery over the last 20 years. With minimally invasive techniques, many procedures take less time, require less anesthesia, and use much smaller incisions. The Chester County Hospital physicians are well-trained and experienced in the latest surgical techniques utilizing a minimally invasive approach.
Hysteroscopy uses a telescope-like instrument with a video camera that allows the physician to see inside your uterus. The procedure is commonly used to diagnose problems of the lining of the uterus, including endometrial polyps, submucosal uterine fibroids, and uterine anomalies. It is also used for the treatment of fibroids, polyps, dysfunctional bleeding, and endometriosis. Compared with other more invasive procedures, hysteroscopy is a relatively safe procedure and offers the following advantages:
- Shorter hospital stay
- Shorter recovery time
- Less pain medication needed after surgery
- Avoidance of hysterectomy
- Possible avoidance of "open" abdominal surgery and potential need for C-sections in the future
Laparoscopic surgery is performed using an instrument called a laparoscope (a thin, lighted telescope) that is inserted through a tiny, half-inch incision made in the navel. The laparoscope allows the physician to see and operate in the abdomen without having to use a long incision. Two or three smaller incisions are made along the sides of the abdomen to allow the passage of highly specialized surgical instruments.
Laparoscopic techniques allow surgery to be performed with less trauma to patients and minimal damage to body tissues. This often means fewer days in the hospital and much less pain during recovery. In many cases, patients go home the same day or the next morning.
Laparoscopic surgery can be used to address a number of gynecologic conditions that once required large incisions. These procedures include:
- Total Laparoscopic Hysterectomy (TLH)
A laparoscope is used to remove the entire uterus from the abdomen. The ovaries may or may not be removed at the same time.
- Laparoscopic Supracervical Hysterectomy (LSH)
In the laparoscopic supracervical hysterectomy, the uterus is removed, leaving a portion of the cervix behind. The ovaries may or may not be removed at the same time.
- Laparoscopic Burch Procedure
In the laparoscopic burch procedure, a laparoscope is introduced through the navel and two other incisions about a half-inch long are placed in the lower abdomen. The space between the bladder and the pubic bone is opened, and permanent stitches are used to anchor the neck of the bladder behind the pubic bone. Often extra stitches are used to secure the rest of the bladder into position. This step is called a paravaginal vault suspension.
- Laparoscopic Vault Suspension
When the tissue and ligaments that hold pelvic organs in place begin to fail, the resulting pelvic prolapse can sometimes be corrected via laparoscopic surgery. Using the laparoscope and two additional half-inch incisions in the lower abdomen, permanent stitches are used to reattach the prolapsing vagina to the uterosacral ligaments. This procedure is frequently used in combination with other procedures such a laparoscopic paravaginal vault suspension or posterior repair.
- Endometrial Ablation
Endometrial Ablation is a procedure where all or part of endometrium (the lining of the uterus) is removed or destroyed in an effort to reduce vaginal bleeding. While some patients will cease to have menstrual periods, others may continue to have periods with a lighter flow. The procedure usually requires vaginal placement of a hysteroscope to allow the physician to see the endometrium.
- Tension-free Vaginal Tape Sling Procedure (TVT)
Tension-free vaginal tape placement is a vaginal procedure used to correct stress urinary incontinence and a disorder called intrinsic sphincter defect. Through a small vaginal incision, the physician places a permanent mesh-like material underneath the urethra and anchors it to the abdominal muscles above the pubic bone. The mesh-like material remains as a permanent sling under the urethra, preventing incontinence when straining or coughing.
Last Updated: 7/1/2009