A total hysterectomy is the surgical removal of the uterus and cervix. This operation is one of the most common in gynecologic practice.The procedure can be lifesaving for those suffering from heavy bleeding due to fibroids, adenomyosis or severe pain due to endometriosis or gynecological cancers . A hysterectomy is major surgery, but with new technological advances, the discomfort, risk of infection and recovery time has all been decreased remarkably .There are currently three surgical approaches to hysterectomies. These include:1. Open, traditional hysterectomy. This involves a six to eight inch incision made in the abdominal wall.2. Vaginal Hysterectomy. This involves removing the uterus through the vagina. This approach is better than the open, traditional hysterectomy, but still does not allow the surgeon a full view of the surrounding organs, including the bladder& ureter.3. Total Laparoscopic Hysterectomy. Using a laparoscope , a slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments , gynecologists have the ability to see inside the abdomen and technical access to the uterus, ovaries and fallopian tubes without having to make a large incision. The duration of total laparoscopic hysterectomy varied 40-80 minutes (average 60 minutes). With advanced laparoscopic skills, gynecological surgeons are able to perform TLH. The surgery is completed utilizing only four tiny abdominal incisions 5mm to1cm long. Even a very large uterus can be removed laparoscopically using this technique. It offers numerous potential benefits over traditional approaches, particularly when performing more challenging procedures like radical hysterectomy for gynecologic cancer.3 primary reasons for hysterectomy include:.Removal of fibroids, which are non-cancerous tumors.Treatment of endometriosis, the growth of the uterine lining outside of the uterus Resolve uncontrolled bleeding caused by adenomyosis, cancer or pelvic organ prolaspe.Less blood loss.Fewer complications.Less scarring.Decreased risk of infectionPost surgically, patients have a much quicker recovery, usually going home the same day or stay one overnight in the hospital. Often, patients are able to return to their normal routine in one to two weeks. Patients report less pain, minimal post-surgical pain medication use, and a faster recovery time than women undergoing abdominal hysterectomies who usually require a four to five days hospitalization and lengthy recovery time of usually six to eight weeks.

In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions.Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall.Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console.Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).Laparoscopic and robotic surgery use smaller incisions than a myomectomy, or laparotomy, does. This means you may have less pain, lose less blood and return to normal activities more quickly than with a laparotomy.Hysteroscopic myomectomyTo treat fibroids that bulge significantly into your uterine cavity (submucosal fibroids), your surgeon may suggest a hysteroscopic myomectomy. Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.A hysteroscopic myomectomy generally follows this process:1. Your surgeon inserts a small, lighted instrument — called a resectoscope because it cuts (resects) tissue using electricity or a laser beam — through your vagina and cervix and into your uterus.2. A clear liquid, usually a sterile salt solution, is inserted into your uterus to expand your uterine cavity and allow examination of the uterine walls.3. Using the resectoscope, your surgeon shaves pieces from the fibroid until it aligns with the surface of your uterine cavity. The removed fibroid tissue washes out with the clear liquid that's used to expand your uterus during the procedure.Rarely, your surgeon may use a laparoscope inserted through a small incision in your abdomen to view the pelvic organs and monitor the outside of the uterus during a complicated hysteroscopic myomectomy.After the procedureAt discharge from the hospital, your doctor prescribes oral pain medication, tells you how to care for yourself, and discusses restrictions on your diet and activities. You can expect some vaginal spotting or staining for a few days up to six weeks, depending on the type of procedure you've had.

FAMILY PLANNING FELLOWSHIPOur family planning services include a wide range of gynecological care and birth control methods.Fees are based on the service you receive.Please call our helpful staff for more information.FAMILY PLANNING SERVICESAccurate, modern ultrasoundBirth control and breast examsCervical Cap fittingComplete GYN exam including, breast exam and pap smearConvenient, state-of-the-art lab testingDiaphragm fitting § Depo-Provera, contraceptive injectionFree birth control pills with examFree pregnancy testingHIV testing (confidential and/or anonymous)Individual patient education by warm courteous professionalsIUD, ParaGard T380A or Progestasert, hormonal IUD (Levornorgestrol)Morning After Pill, emergency contraceptionNuva Ring, contraceptive ringOrtho Evra, contraceptive patchPost abortion check-up and examsSTI, Sexually Transmitted Disease (Screening and Treatment)Tubal ligation referralINFERTILITYPREPARING FOR YOUR APPOINTMENTDepending on your age and personal health history, your doctor may recommend a medical evaluation. A woman's gynecologist or a man's urologist or a family doctor can help determine whether there's a problem that requires a specialist or clinic that treats infertility problems. Both you and your partner will likely have a comprehensive infertility evaluationTO GET READY FOR YOUR FIRST APPOINTMENT:Provide details about your attempts to get pregnant. Your doctor will need information such as when you started trying to conceive and how often you've had intercourse, especially around the midpoint of your cycle — the time of ovulation.Bring your key medical information. Include any other medical conditions you or your partner has, as well as information about any previous evaluations or treatments for infertility.Make a list of any medications, vitamins, herbs or other supplements you take. Include the doses and how often you take them.Make a list of questions to ask your doctor. List the most important questions first in case time runs outFOR INFERTILITY, SOME BASIC QUESTIONS TO ASK YOUR DOCTOR INCLUDE:What are the possible reasons we haven't yet conceived?What kinds of tests do we need?What treatment do you recommend trying first?What side effects are associated with the treatment you're recommending?What is the likelihood of conceiving multiple babies with the treatment you're recommending?For how many cycles will we try this treatment?If the first treatment doesn't work, what will you recommend trying next?Are there any long-term complications associated with this or other infertility treatments?