Surgical Options

In some infertility cases, surgical procedures may be helpful – and necessary. Innovative technology has changed the way many gynecologic procedures are performed. In fact, many traditional surgeries are being replaced with minimally invasive techniques.
Below are answers to the most frequent questions we get about surgical procedures.
How does minimally invasive surgery differ from more traditional surgery?
Traditional surgery involves making a much larger incision, usually five inches or more. It leads to a longer recovery time, larger scar, and increases the risk of adhesions or scarring within the abdomen. The hospital stay is usually three days or longer. The patient typically does not return to work for four to six weeks. Minimally invasive surgery allows for a quicker recovery and less pain.
How long does it take to recover?
Most patients go home the same day as the surgery is performed. Patients are able to get up and around that evening. Although removing the entire uterus usually requires an overnight stay in the hospital, most patients are up out of bed the next morning and go home early in the day.
What is hysteroscopy?
Hysteroscopy is minimally invasive surgery for the inside of the uterus. The cervix (the part of the uterus that opens into the vagina and through which a baby passes during delivery) is opened to less than half-inch in order to perform surgery. Through this opening a narrow instrument with a video lens at the end is passed through into the uterus. Other instruments can then be passed through alongside the lens, these instruments are used to grasp, cut or vaporize abnormal tissue. In this way, polyps, fibroids and inborn defects of the uterus can be removed.
What is laparoscopy?
Laparoscopy is minimally invasive abdominal surgery performed through very small incisions in the abdomen, generally a half-inch or less. The lens of a small camera is placed through one incision so that the inside of the abdomen may be seen on a TV screen. Two or three other instruments are then placed through the other incisions. These instruments can hold, cut and suture tissue, allowing the experienced laparoscopic surgeon to perform even complex surgeries. A large fibroid or even a entire uterus can then be removed through these small incisions by cutting the fibroid or other tissue into thin strips while inside the abdomen.
Who can perform gynecologic minimally invasive surgery?
Many physicians trained in gynecology can perform some types of laparoscopy and hysteroscopy. However, the extent and difficulty of the surgery they perform in this way depends on their specific training and comfort levels. Gynecologists who have completed a fellowship in reproductive endocrinology and infertility, such as the physicians at Specialists in Reproductive Health, receive much more extensive training in advanced minimally invasive surgery.