Surgical and non-surgical procedures may be needed at some point in a woman’s life.  Associates in OB/GYN offer minimally invasive laparoscopic surgery, endometrial ablation, hysteroscopy, incontinence surgery, hysterectomy and permanent sterilization procedures.

view video

Colposcopy is used as a follow- up to an abnormal pap smear screening.  In some women, a pap smear will show an abnormality.  In these cases the cervix can be further examined by a procedure called colposcopy.  A colposcope is an instrument that magnifies the cervix and, with the application of acetic acid on the cervix, the area of abnormal cells can be detected and a biopsy may be taken.  This way, the doctor can tell more precisely the degree of abnormality and decide on the best method of treatment or management of a particular abnormality.

Although most people think first of the obstetrical uses of ultrasound, it is an equally valuable tool in gynecology. It is very useful in the evaluation of ovarian masses, uterine fibroids, and many other gynecologic conditions. In the evaluation of abnormal bleeding, a special ultrasound procedure called a sonohysterogram may be recommended. This involves inserting a small tube into the cervix and instilling a small amount of saline solution into the uterus. This allows a very thorough evaluation of the inside of the uterus, and frequently allows the patient to avoid more involved procedures requiring hospitalization and general anesthesia. Our gynecologic ultrasounds are performed by certified sonographers with many years of experience.

Hysteroscopy

Hysteroscopy is an outpatient procedure that allows direct visualization of the inside of the uterus.  It is usually performed while the patient is asleep.  The cervix is gently dilated and then a camera is inserted through the cervix into the uterine cavity.  Hysteroscopy allows us to directly see polyps, some fibroids, the tubal openings and other types of uterine cavity abnormalities.  During hysteroscopy, many other procedures can be done such as dilation and curettage (D &C), removal of polyps, destruction of certain fibroids, tubal ligation and endometrial ablation.

Essure (permanent sterilization)

This is a permanent birth control method where small spring-like coils are placed via hysteroscopy into the openings where the fallopian tubes enter the uterus.  There are a few contraindications along with a few complications that need to be discussed with your doctor.  This procedure does require that a hysterosalpingogram (HSG) be performed 3 months after placement to confirm complete blockage of the fallopain tubes.  Another form of birth control must be used until the HSG is performed.  The Essure can also be done with oral and local analgesia in the office.

D &C  (dilation and curettage)

This minor gynecological procedure, Dilation and Curettage ( D & C), can be performed for various reasons.  Sometimes done in conjunction with a hysteroscopy, it may be used to empty the uterus after an incomplete miscarriage, diagnose endometrial cancer (inside lining of uterus) or to stop uterine bleeding.  A D & C usually requires anesthesia and is performed at the hospital as an outpatient procedure. 

Sterilization procedures are a common form of contraception.  After abstinence and hysterectomy, they are the most effective form of birth control.  A tubal ligation involves blocking the fallopian tubes with cautery, clips or sutures, either done via the umbilicus or above the pubic bone.  Tubal ligation is considered a minor surgical procedure, it requires anesthesia and usually performed as an outpatient procedure. 

Endometrial Ablation

Endometrial ablation is an outpatient procedure designed to decrease or eliminate heavy menses (periods) or abnormal bleeding.  While the patient is asleep, hysteroscopy is performed to directly visualize any abnormalities.  Following this, a device is used to completely burn the uterine lining. The procedure takes anywhere from 90 seconds to 8 minutes, depending on the patient’s age and cause of bleeding.  Thirty to seventy percent of women may never had a period again.  Most women will have markedly lighter periods  afterwards, despite the fact that the cavity has been burned.  There is minimal pain involved. 

TVT - Tension Free Vaginal Tape

Many women suffer from genuine stress urinary incontinence, which is leaking urine whenever they cough, laugh, or sneeze. Women often accept this as a sign of "getting older", however, a new procedure called tension free vaginal tape (TVT) can be extremely beneficial in helping women with this significant problem.

The procedure is most often performed on an outpatient basis. It consists of placing a small tape or ribbon under the urethra, which serves as a backstop that pinches off the urethra and prevents incontinence when coughing, laughing, or sneezing. It is extremely effective in treating most cases of genuine stress incontinence. The physicians at AOG are skilled in the performance of this new procedure.

Childbirth and aging can cause damage to the tissues that support the pelvic organs.  This can result in the symptom  of pelvic pressure or the actual bulging of the bladder, cervix or rectum through the vagina.  Associated symptoms include loss of urine with coughing, sneezing or straining or difficulty having a bowel movement. 

If conservative management with special exercises, dietary changes, medical treatment or insertion of a support device called a pessary, is not successful, then surgical management may be necessary.  After assessment of a patient’s symptoms and evaluation of her actual pelvic support defects, surgical options can be discussed.  AOG offers the newer minimally invasive laparoscopic procedures that correct the defects but significantly reduce the recovery time.

Approximately 80% of hysterectomies done in the United States are done through a large abdominal incision. The healing process from this operation usually requires a three-day hospital stay and approximately 6-8 weeks before returning to work.

By using a minimally invasive surgical technique called laparoscopically assisted vaginal hysterectomy (LAVH) most abdominal hysterectomies can be converted to vaginal hysterectomies. The recovery time from an LAVH is much shorter with an under 24-hour hospital stay and return to normal activities and work in approximately two weeks. The physicians at AOG have been performing LAVH procedures since 1992, and many patients over the years have benefited tremendously from this new technology.

Occasionally it is necessary to have complete or partial removal of an ovary.  Women can develop both benign and malignant tumors of the ovary.  Benign tumors of the ovary can often be removed through the laparoscope.  This outpatient surgery allows you to have a more rapid recovery.

Ovarian Surgery

Occasionally it is necessary to have complete or partial removal of an ovary.  Women can develop both benign and malignant tumors of the ovary.  Benign tumors of the ovary can often be removed through the laparoscope.  This outpatient surgery allows you to have a more rapid recovery.