This site offers a discussion of available minimally invasive options for treatment of common gynecologic problems. Patients are always presented with available medical and surgical options for management. Even observation is presented when it is appropriate. I also include discussion of options that are available that I may not offer.

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Sunday, March 25, 2007

Removal of Cervix after Supracervical Hysterectomy or LSH

I have had a few patients who have presented to me for problems after a supracervical hysterectomy or LSH. This type of hysterectomy is typically performed laparoscopically. The uterus is divided into two portions; the top or fundus, and the bottom or cervix. As described in a previous post in January of 2007, the supracervical hysterectomy can be a good procedure for patients desiring a fast recovery. There is also some benefit by not disrupting the existing supportive ligaments that attach at or near the level of the cervix.

However, up to 30% of patients may need to have the cervix removed at a later date due to continued bleeding, continued pain, or other problems. Most of the patients I have encountered request removal of the cervix due to continued pelvic pain or pain with intercourse after having a supracervical hysterectomy.

Removal of the cervix can be completed by three different methods. It can be removed by vaginal surgery. The risk with this method is the possibility of adhesions to the amputated cervix. Another method is through a laparotomy or large incision. The third method is with the laparoscope. Much in the same way a hysterectomy is performed, the laparoscope allows evaluation of the abdominal cavity for adhesions and also allows completion of all or part of the removal of the cervix.

As with hysterectomy patients are chosen for method of removal based upon their risk of adhesions, continued pain, and amount of cervical descent. Offering laparoscopy allows the physician and patient to choose between all available methods for surgery.

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Minimally Invasive Procedures Offered

  • Hysterectomy - Out Patient Surgery and No Large Incisions
  • Endometriosis
  • Uterine Prolapse
  • Cystocele/Bladder Repair
  • Enterocele
  • Ovarian Cysts
  • Adhesions
  • Stress Incontinence
  • Uterine Fibroids
  • Da Vinci Robotic Assisted Surgery

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