Surgery fibroids, endometriosis, and incontinence


Our doctors have been performing surgery with the most advanced technology available for over 10 years. Richmond area’s most experienced practice using the da Vinci® Surgical System for minimally invasive, robotic gynecological surgery.

When medication and non-invasive procedures aren’t able to relieve symptoms, surgery is still the accepted and most effective treatment for a range of gynecological conditions. These include cervical and uterine cancer, uterine fibroids, endometriosis, uterine prolapse, and menorrhagia or excessive bleeding, and other problems. Our capabilities allow us to perform many of these procedures in-office instead of the hospital.

Minimally or Non-invasive Surgery

Fortunately, less invasive options are available today thanks to technology like the da Vinci Robitc system. Some surgery can be performed using a vaginal approach which may not even need an external incision. For other surgeries, laparoscopic or robotic surgery may be the most effective, least invasive treatment.

Laparoscopy uses a tiny incision in the abdomen through which a thin tube is inserted. The tube, called a laparoscope allows your surgeon to see the affected area. If a problem is spotted, instruments are inserted through the laparoscope or through other small cuts around the abdomen to complete the surgery. With the da Vinci system, your surgeon uses 1-2 cm incisions to reach the affected area and manipulates da Vinci’s tiny instruments to precisely remove the affected area or treat the problem.

The benefits of minimally invasive surgery include less pain and risk associated with large incisions, and that usually shortens recovery time. For example a minimally invasive hysterectomy may mean 2-3 weeks recovery versus 6-8 weeks for a traditional hysterectomy.

To learn more about the da Vinci Surgery System, visit the da Vinci Community Online.  Here Dr. Danny Shaban discuss endometriosis and the use of the da Vinci Surgery treatment.

Types of Surgeries We Perform

We perform a full range of gynecological surgeries to treat many gynecological and obstetrical conditions. including the following procedures:

Colposcopy uses a special device that shines a light onto the cervix and also magnifies the area. It’s used to find problems that can’t be seen by the eye alone. Colposcopy gives us more information about results of an abnormal cervical screening. It’s also used to assess problems such as an inflamed cervix, polyps (benign growths), pain, and bleeding. If something abnormal is found, we may also take a biopsy during the procedure. Colposcopy is an in-office procedure.

Dilation and Curettage (D&C) uses a thin instrument that’s inserted into the uterus to remove sample tissue for testing. D&C is used to diagnose and treat a number of conditions like unusual bleeding. It’s done in the office. You may have some type of anesthesia, if so, you’ll need someone to take you home. You may have mild pain, spotting or light bleeding after a D&C.

Endometrial Ablation is used to treat causes of heavy bleeding by destroying a thin layer of the uterine lining. If heavy bleeding can’t be controlled with medication, this is often the next step. Several methods can be used, all of them can be performed in- office:

  • Radio frequency uses energy and heat to destroy tissue; suction removes the tissue.
  • Freezing uses a thin probe to freeze the lining. Ultrasound is used to guide the probe.
  • Heated fluid is sent into the uterus using a hysteroscope, a slim device. The heated fluid destroys the lining.
  • Heated balloon uses a balloon that’s inserted and filled with heated fluid. The fluid expands so the balloon touches the uterine walls and the heat destroys the lining.
  • Microwave energy is sent through a special probe that’s inserted into the uterus to destroy the lining.
  • Electrosurgery uses a slim telescope-like device that has an electrical loop or special tip to destroy the lining. This usually done in an operating room, and you’re under anesthesia.

Hysterectomy is when the uterus is removed for a variety of medical reasons. It can be performed vaginally in some cases, or through minimally invasive surgery, or may require traditional, open surgery. The procedure is performed in a hospital or an outpatient surgery center. After a hysterectomy, your periods stop and childbearing ends. We understand hysterectomy can also be an emotional decision and will explore all options with you before taking this step.

Hysterectomy may trigger menopause regardless of your age. There are three types of hysterectomies:

  • Total where the uterus and cervix are removed.
  • Supracervical where cervix is left in but the upper part of the uterus is removed.
  • Hysterectomy with removal of fallopian tubes and ovaries.

Laparoscopic Supracervial Hysterectomy (LSH) uses laparoscopy to remove the uterus through one of the openings. This type of surgery leaves the cervix intact which in turn helps maintain good pelvic floor support. LSH is performed in a hospital or outpatient surgery center.

Pelvic Prolapse Surgery is an option used to restore a pelvic organ to its normal position after dropping. Prolapse surgery is done through an incision in the vagina or the abdomen, or by laparoscopy. Surgery is performed in a hospital or outpatient surgery center. Non-surgical treatments are used generally tried before surgery.

Stress Urinary Incontinence Surgery may be used to treat urinary incontinence. If non-surgical options don’t work, surgical options are available using either an abdominal incision or laparoscopy. Options include inserting and attaching a sling that acts as a “hammock” to lift and hold the urethra and neck of the bladder, or by using carefully placed stitches to raise the bladder back into position. Surgery is performed in a hospital or outpatient surgery center.

Traditional, “Open” Surgery

Sometimes complex medical problems or health issues exist that require the more traditional, “open” surgery. Open surgery uses a larger incision so your physician can get to the uterus and surrounding area. Traditional surgical instruments are used to skillfully remove or treat the affected area. Our surgeons are very experienced at minimizing side effects as much as possible. Recovery time is longer and discomfort greater with open surgery but be assured that we’ll explore all options with you to decide the best way to treat your condition.

Inpatient or Outpatient?

We’re please to have the capabilities necessary to safely and effectively perform a great many procedures in our offices. da Vinci surgery is performed in a hospital or outpatient surgery center. It’s usually an outpatient procedure but in certain situations, may require an overnight stay. Other minimally invasive procedures can be performed in the office, for example, a D&C. Traditional, open surgery is performed in a hospital or outpatient surgery center. If it’s a complex procedure like a hysterectomy, you usually spend at least 1-2 nights in the hospital.

If you have anesthesia or a sedative for an in-office procedure, you’ll need a responsible adult to drive you home. We’ll talk with you about what to expect in advance so you can make arrangements for a ride or for someone to help you when you get home if necessary.

Hear one patient tell her story about having a hysterectomy using the da Vinci robot.

Patient has hysterectomy with da Vinci robot.