For 50 years, ambulatory surgery centers (ASCs)—freestanding, fully licensed facilities for outpatient surgeries—have provided an alternative to hospital-based surgery in the United States. Now, with the uncertainty of the COVID-19 pandemic and many people still concerned about getting the virus, the inherent safety advantages of ASCs over hospitals have helped them become an even more important part of the health care landscape.

 Small and Specialized

Women who need to have elective gynecological surgery but are concerned about COVID-19 can confidently move forward with it at an ASC like those used by The Center for Innovative GYN Care. Among the reasons:

  • ASCs perform only outpatient surgery. An outpatient procedure is one that can be performed in a few hours or less (thus requiring less time under anesthesia) and allows patients to return home the same day.
  • As is the case with CIGC’s GYN-only surgical practice, ASCs usually only treat patients in one or perhaps a few specialty areas (orthopedics or urology, for example) whereas hospitals have among their varied cases patients who already have COVID-19.
  •  ASCs treat far fewer patients in a day and have fewer staff members in the rooms, so there is less risk of being exposed to someone who is asymptomatic (not showing symptoms) yet still capable of transmitting the virus.
  • ASCs have a smaller footprint than hospitals, which makes them easier to sanitize and control for safety measures such as personal protective equipment for surgical staff, mask wearing and proper distancing, screening patients and staff for cold and flu-like symptoms and more.
  • ASCs follow the latest recommendations from the Centers for Disease Control, state departments of health and leading medical associations.

No Waiting

Getting care at an ASC during the pandemic can also be a woman’s safest option because it will likely be her fastest option.

Many hospitals are still trying to catch up on elective surgeries that were canceled during pandemic shutdowns, and the wait to be rescheduled can be long. Prompt care during COVID-19 and a transfer of cases from hospitals to ASCs was recommended by the American College of Surgeons and the American Association of Gynecologic Laparoscopists.

A woman who has fibroidsendometriosis or another GYN condition must not only deal with aggravating symptoms longer, but she also risks her untreated condition getting worse. In just one example, fibroids that grow unchecked can become large enough to cause dangerous bleeding, kidney damage, miscarriage and more.

Today, nearly 6,000 ASCs perform about 35% of all surgeries. And their role in providing safe, rapid care will only continue to expand.

Searching for a safe way to have GYN surgery during COVID-19? Talk to a CIGC patient advocate today.

Paul J. MacKoul, M.D.

Laparoscopic surgery specialist Dr. Paul MacKoul is co-founder of The Center for Innovative GYN Care and CEO of Tower of Surgical Partnersa GYN ASC management company headquartered in Rockville, Maryland. 

View Bio

Of the many arenas in our society affected by the COVID-19 pandemic, lack of prompt medical care for severe gynecological conditions stands out as one that has not received the widespread attention it deserves. This is concerning because delaying surgery can have serious ramifications for patients.

It has been months now since many hospitals, physicians’ offices and other health care facilities reopened after mandatory shutdowns issued in many parts of the country, and yet we are still digging out from the backlog of elective surgeries caused by the closures. Some experts estimate it will take a year for surgery volume to return to normal.

Nothing Normal about GYN Symptoms

It is unfortunate that many women’s gynecological symptoms were considered non-essential during shutdowns. It is perhaps even more unfortunate that many women themselves saw, and continue to see, their situations in the same light:

It is unfortunate that many women’s gynecological symptoms were considered non-essential during shutdowns. Perhaps even more unfortunate that many women themselves saw, and continue to see, their situations in the same light: The idea that pain and bleeding are normal is often ingrained in women and passed down through generations. But there is nothing about debilitating pelvic painextreme bleeding or other problems that warrants a delay in treatment, and these problems should never be categorized or stigmatized as such.

If you are experiencing symptoms that are interfering with your normal activities or your ability to enjoy life as you once did, know that your GYN health deserves to be prioritized. In fact, it needs to be: Chronic, untreated GYN conditions and disease can lead to more serious problems.

Find Relief from Fibroids

Complications and Consequences

How might this escalation manifest? A general example is when prolonged bleeding requires a patient to receive a blood transfusion before surgery has even begun: This could trigger the need for a more complex surgical procedure, which could in turn lead to a higher risk of complications or the need for a more invasive procedure with greater pain and a longer recovery time.

Fibroids are another example of why treatment should not be put off. In many cases, waiting too long can cause:

  • Prolonged bleeding and anemia, which is a chronic shortage of red blood cells that can lead to fatigue, headache, weakness and shortness of breath.
  • Kidney damage, if the fibroids grow large enough to press on the ureter and impede urine from draining into the bladder.
  • Miscarriage, if fibroids grow during pregnancy.
  • Bowel or circulatory problems, which can develop when large fibroids take up too much space in the pelvic cavity.

In the case of precancerous or early stage cancer, disease progression may result in the cancer registering at a higher stage upon diagnosis. It also can result in the need for additional therapy after surgery such as radiation or chemotherapy.

ASCs Can Deliver Care Without Delay

Women who are experiencing delays in care from hospital backlogs — or who may be putting off seeking treatment due to worries about COVID-19 exposure in the hospital environment — have an alternative. They can have their surgery with a GYN specialist who is based at an ambulatory surgery center (ASC) like The Center for Innovative GYN Care.

ASCs are freestanding outpatient surgery facilities that are independent from hospital systems, which gives them a higher level of efficiency and control over quality of care. Surgeries can be easily scheduled and performed without long waits, often at less cost to the patient.

ASCs have no ICU, no ER and no inpatient ward. In CIGC’s case, it is dedicated to only gynecological surgeries, whereas hospitals treat patients with everything from injuries to COVID-19. And ASCs have a small, easier-to-control footprint that can be safeguarded from viruses with greater efficiency.

No one knows how long the COVID-19 pandemic will continue to affect hospital-based health care. But even if the virus were to disappear tomorrow, ASCs would continue to be ideal facilities for timely treatment of GYN conditions.

Dr. Paul MacKoul

Paul MacKoul, M.D., is board certified in gynecology and fellowship trained in gynecologic oncology. He is a specialist in the minimally invasive treatment of complex GYN conditions such as fibroids, ovarian masses and endometriosis, as well as early-stage GYN cancer. He is the co-founder of The Center for Innovative GYN Care.

View Bio