Considerations for Gynecologic Surgery

By Natalya Danilyants, MD

Women who live in the metropolitan Washington D.C. region are lucky. There are more gynecologists in this area than in any other region in the country. Therefore, most women can choose among several doctors for routine gynecologic and obstetrical care.
When women begin to suffer from some of the most common gynecologic conditions, from fibroids to pelvic pain, endometriosis or urinary incontinence, they often first seek advice from the doctor who has been performing their annual pap smears or who delivered their babies. Not surprisingly, these doctors typically convince their patients to have surgery with them, since they have an existing relationship. However, women need to be empowered to make careful choices before having surgery. Choosing a highly skilled surgeon is far more important than going with a doctor who delivered your babies or has treated you for urinary tract infections.
OB/GYNs are trained to deliver babies, provide prenatal care, and perform routine office visits. According to the American College of Obstetrics and Gynecology, 80% of the average OB/GYN practice is dedicated to obstetrical care. Only a small fraction of their time is spent in surgery. The average American gynecologist performs only 24 surgeries per year. Given how little surgery OB/GYNs actually do, it is no wonder most do very little laparoscopic or minimally invasive surgery.
Minimally invasive surgery has long been known to be better than open surgery for patients. Minimally invasive surgery offers tiny incisions, less blood loss, minimal pain and faster recovery. However, many OB/GYNs havent had significant training in laparoscopic techniques and therefore tell patients that they “cant have laparoscopic surgery” because of their condition. If you have been told this by your doctor, you should seek a second opinion from a specialist who has received additional training in laparoscopic surgery for gynecology.
Advanced laparoscopic surgery is a new development in the field of laparoscopy. Using advanced laparoscopic techniques, all patients are candidates for laparoscopic surgery, including those with complex gynecologic problems, large fibroids and/or ovarian masses, as well as very overweight patients or those with many prior surgeries. Even patients with gynecologic cancers can receive minimally invasive surgery if they seek out a specially trained advanced laparoscopic surgeon.
If you are considering treatment for your gynecologic condition, consider a consultation with a surgeon who has completed a laparoscopic surgery or gynecologic oncology fellowship. The additional training enables these surgeons to help women solve their gynecologic problems permanently, with minimal pain and interruption to their lives. Be sure you have all the facts, get a second opinion with a gynecologic surgery specialist.