Gynecologic surgeries are surgical procedures of the female reproductive system. These procedures include invasive and minimally invasive surgeries for infertility, incontinence, cancer and benign conditions.
What are gynecologic surgeries?
Gynecologic surgeries are surgical procedures of the female reproductive system. These procedures include invasive and minimally invasive surgeries for infertility, urinary incontinence, cancer and benign conditions. They can also be elective and performed for cosmetic reasons. The gynecological surgeries Dr. Lawrence Eisenhauer performs are endometrial biopsy, endometrial ablation and hysterectomy.
What is an endometrial biopsy?
Endometrial biopsies are performed to collect a small tissue sample from the endometrium (the lining of the uterus) for further examination. Dr. Eisenhauer may suggest an endometrial biopsy for the following reasons:
- If you experiencing abnormal menstrual bleeding
- If there is an absence of uterine bleeding
- If you experience bleeding after menopause
- To check the effects of menopausal hormone therapy
- To find abnormal cells or endometrial cancer
Dr. Eisenhauer may recommend an endometrial biopsy for another reason, but he will discuss it with you fully during your appointment. Please feel free to discuss any questions or concerns that you have with him.
What happens during an endometrial biopsy?
Similar to a pelvic exam, you will lie down with your legs and feet supported. A speculum is used to spread the walls of the vagina so that the cervix can be viewed. The cervix is then cleaned, numbed and held steady by an instrument similar to forceps.
Dr. Eisenhauer may then insert a uterine sound (a thin, rod-like instrument) through the cervical opening to determine the length of the uterus and the location for the biopsy. Once this has been done, the uterine sound is removed. Next, a catheter with a smaller tube inside of it is inserted into the uterus, and the inner tube creates a suction effect. Dr. Eisenhauer will use this catheter to collect small samples of endometrial tissue. After the samples have been collected, the catheter and speculum are removed and the procedure is over. The samples are then sent off to a lab for review.
What is endometrial ablation?
Endometrial ablation is a surgical procedure that destroys the endometrium (the lining of the uterus) in order to reduce or stop menstrual flow. Dr. Eisenhauer can perform this procedure in our office, although the size and condition of your uterus will help to determine which endometrial ablation method is most appropriate. This procedure is recommended if you have:
- Anemia from excessive blood loss
- Unusually heavy periods
- Bleeding that lasts longer than a normal cycle
If you are postmenopausal or you have a pelvic infection, uterine cancer (or are at a high risk of uterine cancer) or you have certain abnormalities of the uterus, this surgery is generally not recommended.
What happens during endometrial ablation?
Before the procedure, the opening of the cervix needs to be widened in order to allow for the passage of surgical instruments. Medication or a series of rods can be used to dilate the cervix. The actual procedure will depend on the method that your doctor uses. Dr. Eisenhauer uses the NOVASURE radiofrequency (RF) device (a bipolar electrical unit for safety). These methods include:
- Cryoablation – extreme cold is used to freeze and destroy the endometrium*
- Electrosurgery – a wire loop is heated and used to carve furrows into the endometrium*
- Heated balloon – a balloon device is inserted through the cervix and is then inflated with heated fluid*
- Radiofrequency (RF) – a flexible device transmits radiofrequency energy that vaporizes endometrial tissue (NOVASURE)*
- Microwave – a slender wand is inserted through the cervix and emits microwaves to heat the endometrial tissue*
- Free-flowing hot fluid – heated saline fluid is circulated within the uterus for 10 minutes
What is a hysterectomy?
One of the more common gynecological surgeries is a hysterectomy. Hysterectomies are surgical operations that are performed to remove part or all of the uterus. For some women, the cervix, ovaries and fallopian tubes may also be removed during the procedure.* Dr. Eisenhauer may suggest a hysterectomy to treat or address:
- Uterine fibroids
- Uterine prolapse
- Gynecologic cancer
- Abnormal menstrual bleeding
- Chronic pelvic pain
Most women wait to have their hysterectomy after they’ve made the decision to no longer have children. Following the procedure, you will no longer be able to become pregnant. If you choose an alternative option to address the issues above, you may need additional treatment later.* We can discuss all of the available treatment options with you.
What happens during a hysterectomy?
Gynecologic surgeries like hysterectomies vary from patient to patient. A total hysterectomy removes the entire uterus along with the cervix. Supracervical hysterectomies only remove the upper part of the uterus and the cervix is left in place. A radical hysterectomy is a similar to the total procedure, but structures around the uterus are also removed.
Additionally, there are multiple ways in which this procedure can be performed. Dr. Eisenhauer can perform vaginal, abdominal or laparoscopic hysterectomies (minimally invasive techniques.). The differences between these procedures involve how the uterus is removed. With vaginal, the uterus is removed from the vagina, and with abdominal, the uterus is removed from the abdomen. With the vaginal procedure there will be no incisions through the abdomen and patients typically experience fewer complications, shorter healing times and a faster recovery.*
Abdominal procedures are the opposite and are only performed if a vaginal hysterectomy is not an option. A laparoscopic hysterectomy relies on small incisions (half an inch in length) in the abdomen and the use of a laparoscope–a small, thin tool that has a small video camera and light at the end. The laparoscope is inserted into these small incisions in order for Dr. Eisenhauer to complete the surgery. This can be done to reduce the risks and pain involved with vaginal and abdominal surgeries, but it usually takes much longer to perform.* He specializes in minimally invasive surgical techniques.
Schedule a consultation in Encinitas, California
Schedule an appointment with Dr. Eisenhauer to discuss gynecological surgeries and the options that will help you the most. To take the next step, fill out our online scheduling form or give us a call at (760) 753-8413. We are located in Encinitas and we serve San Diego County and the surrounding areas.