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Doctors performing surgery in operating theater

Minimally Invasive Gynecologic Surgery is Possible

By Sami K. Zeineddine, MD January 31, 2023 Posted in: Women's Health

If you need gynecologic surgery, there is some good news. Instead of the long abdominal incisions and lengthy recoveries, many gynecologic surgeries can now be done with small or even no incisions. That means a much shorter or even no hospital stay, quicker recovery and other benefits.

Why Might Someone Need Gynecologic Surgery?

Called Minimally Invasive Gynecologic Surgery, or MIGS, this approach offers a life-changing treatment option for many women’s health conditions, including:

  • Pelvic pain
  • Endometriosis
  • Pelvic adhesions
  • Irregular periods
  • Uterine fibroids and polyps
  • Prolapsed uterus
  • Ovarian and tubal cysts
  • Pelvic masses
  • Female cancers (ovarian, tubal, cervical and endometrial)

What makes MIGS surgeries different is that they can be done with small ¼-inch incisions or no incisions at all. Most women go home the same day and return back to normal activities within a week or two, depending on the type of surgery. There’s currently four different types of MIGS: laparoscopic, robotic, hysteroscopic and vaginal.

Four Types of Minimally Invasive Gynecologic Surgery

Laparoscopic

Two to four small (1/4 inch) incisions are made near the belly button or at the belly’s hairline. A laparoscope is inserted into the abdomen through one of these incisions. Its miniature camera with a microscope and tiny fiber optic lights provide live images on a high-definition monitor. This allows surgeons to see the entire abdomen and pelvis. Other fine instruments are used to surgically address simple to complex conditions.

Robotic

Surgical instruments are attached to mechanized arms that mimic the surgeon’s hands and wrists. Once inserted through small incisions, the surgeon’s hand movements are transmitted to the robotic instruments. This approach is used for more complex surgeries, such as fibroid removal in a large uterus with multiple fibroids, hysterectomies on patients with multiple prior surgeries and scar tissue, and complex and advanced stage endometriosis.

Hysteroscopic

A narrow instrument called a hysteroscope is inserted through the vagina and cervix into the uterus to allow the surgeon to evaluate the inside of the uterus and treat and remove polyps, fibroids, septum, or an intrauterine device. No incisions are needed.

Vaginal

Also, many surgeries can still be performed vaginally, with no abdominal incision. These include hysterectomy, prolapse and incontinence surgeries.

Benefits of Minimally Invasive Surgeries

A key benefit of MIGS is that laparoscopy, whether it is performed robotically or with laparoscopic instruments, improves visualization of the targeted tissue, and therefore better evaluation and management of a woman’s medical condition. Other benefits include:

  • More surgical precision
  • Better tissue handling
  • Minimal blood loss
  • Minimal pain medications
  • Faster recovery
  • Decreased risk of infection
  • Earlier return to normal activities

Risks of Minimally Invasive Surgeries

Like any other type of surgery, the MIGS approach comes with risks. These include:

  • Anesthesia side effects
  • Infection
  • Bleeding
  • Injury to any nearby structures (bowel, stomach, bladder, ureter, vascular)
  • Musculoskeletal injuries

While the minimally invasive gynecologic surgery is often an option, an open surgery with a larger incision may be appropriate in some cases. To find out if you are a candidate for this type of surgery, talk to your Primary Care or Women's Health provider.

Sami K. Zeineddine, MD

Sami Zeineddine is a Obstetrics and Gynecology provider at CHI Health. To learn more about Dr. Zeineddine, please visit his provider profile.

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