Pelvic and Reproductive Surgery

Some surgical procedures in the pelvic area are done through an incision in the abdominal wall (laparatomy). However, advanced techniques make it possible to perform many procedures using an endoscope, a small telescope with a light source that allows direct visual examination of the ovaries, the exterior of the fallopian tubes, and the uterus. The endoscope can be used to guide surgical instruments or lasers. Laparoscopy is done through a small incision below the navel. Hysteroscopy is done by inserting the endoscope through the cervix into the uterus.

Tuboplasty. When infertility is caused by a blocked fallopian tube, surgical procedures can be used to remove the blockage. In some cases, tuboplasty can be done as an outpatient endoscopic procedure.

Tubal Reanastomosis. Women who have had their tubes tied or cauterized can restore fertility through a surgical procedure that uses microsurgical techniques to reconnect the tubes. The procedure is often lengthy and exacting.

Resection and vaporization of endometriosis: An endoscopic laser procedure can be used to remove endometriosis (endometrial tissue growing outside the uterus). This is usually an outpatient procedure.

Removal of fibroid tumors. A myoma is a benign tumor of fibrous tissue in the wall of the uterus. About 30% of women have fibroid tumors. They may cause no symptoms at all or they may cause abnormal menstrual patterns, pain, or infertility. A traditional fibroid surgery (myomectomy) requires an incision in the abdominal wall. Select cases can be done hysteroscopically.

Removal and Evaluation of Ovarian Cysts. Women in their reproductive years may have a variety of non-malignant ovarian cysts. Removal of cysts may require an abdominal incision, but in many cases the procedure may be done endoscopically.

Removal of scar tissue. Adhesions, or scar tissue, in the fallopian tubes or uterus can be a cause of infertility. In most cases, adhesions can be removed endoscopically as an outpatient procedure.

Correction of uterine anomalies. Infertility caused by congenital anomalies (birth defects) of the uterus, fallopian tubes, and vagina can often be corrected surgically, often with outpatient techniques.

Correction of abnormal bleeding. Abnormal heavy menstrual bleeding that cannot be corrected with hormone therapy can be treated with a surgical technique called endometrial ablation. In this technique, the lining of the uterus (endometrium) is destroyed with safe and rapid surgical techniques.