Considerations For Gynecological Surgery

By Paul MacKoul, MD, FACOG

More than ever before, patients need to be well informed and ready to ask questions in this era of managed care and HMOs. It is especially important to ask questions and obtain as much information as possible when surgery is needed to take care of a gynecologic problem. One of the responsibilities of any patient who must undergo surgery is to determine the exact reason for the surgical procedure, how the surgery will be performed, what the recovery will be, and what specialist can perform the surgery with the least possible complications.
Many surgery patients have undergone open abdominal procedures, which may result in increased pain, complications and longer hospital stays and recovery times. Open procedures require a large abdominal incision, and most patients with large uterine fibroids, ovarian masses, extensive endometriosis, and gynecologic malignancy undergo open procedures for treatment.
Patients who need these procedures today may not know that an alternative is available. It is important to discuss with your surgeon the alternatives of having open surgery versus the more modern approach of laparoscopic surgery.
With technological advances in surgery procedures, many patients can now have minimally invasive surgery
or laparoscopy with better results than traditional open surgery much less pain, significantly shorter hospital stays, and resuming normal activities within days.
Advanced laparoscopic surgery is a new development in the field of laparoscopy that now allows almost every patient with a gynecologic problem to avoid open surgery. Using advanced laparoscopic techniques, patients with complex problems such as very large uterine fibroids and large ovarian masses, or patients with many prior surgeries may qualify for minimally invasive procedures thereby avoiding the problems associated with open surgery.
Why dont all patients undergo advanced laparoscopic surgery instead of open procedures? As more surgeons are trained in this advanced area of surgery, patients may have more laparoscopic procedures, but there arent many physicians with this training at this point.
Many surgeons prefer open procedures because they take less time and are easier to perform. Advanced laparoscopic techniques are much more difficult to learn, and require training and practice.
As a patient, you need to ensure that your physician discusses with you all the options available, including laparoscopic surgery. To be sure you have obtained all the facts, always consider a second opinion from a well trained laparoscopic surgeon, such as a gyn oncologist trained in advanced laparoscopic techniques.