Brittany (30) from Herndon, Virginia had been trying to conceive for four years before coming to CIGC for minimally invasive cyst removal. During surgery, it was discovered she had also been suffering from endometriosis and bowel adhesions. Endometriosis is known to cause infertility as endometrial tissue can affect the ovaries and quality of eggs, and can create toxicity in the lining. After GYN surgery, Brittany got pregnant within a month.
“My daughter is 3 years old now. She is happy, healthy and perfect. It brings tears to my eyes just thinking about the carefulness of the surgery, and being able to keep my ovary and returning to normal within days. I didn’t think that I would end up keeping my ovary and didn’t know if I could ever get pregnant on my own. When that test came back positive my world changed all for the better.” Brittany said.
Pelvic adhesions (scar tissue) are usually caused by multiple pelvic/abdominal surgeries, infection, or endometriosis. Scar tissue can grow between two organs in the pelvic area making them stick together. These pelvic adhesions can occur around the bladder, bowel, ureter, uterus and ovaries. They are also more common after open surgery than laparoscopic surgery.
This scar tissue can be completely asymptomatic and not cause any problems. However, when it causes infertility, pain or gastrointestinal problems, such as bloating and constipation, surgical resection should be considered. Thorough resection of pelvic adhesions is essential in order to relieve pain and avoid new adhesions to form.
Pelvic adhesions can involve different organs:
Bladder adhesions: these usually form after cesarean delivery. Multiple cesarean deliveries lead to dense adhesions between the bladder and the uterus. In order to avoid recurrent adhesions and pain, removal of the uterus through laparoscopic hysterectomy is recommended.
Bowel adhesions: these form after abdominal and pelvic surgeries like myomectomies, or after severe pelvic infection from a ruptured appendix or bowel injury. Careful dissection of the bowel with special scissors is required, and this should only be performed by an experienced surgeon.
Endometriosis adhesions: these can form as a result of extensive or longstanding endometriosis and can cause pain and infertility. These adhesions are usually very dense and involve important structures such as the rectum, large pelvic vessels, and ureters, they can be very difficult to resect. If the patient does not wish to preserve fertility, removal of the uterus with or without the ovaries should be considered.
Ureteral adhesions: these are adhesions around the tubes that connect the kidneys to the bladder. They are found in severe endometriosis. In rare cases, the extent of damage to the ureter from endometriosis requires ureteral reimplantation.
Resection of pelvic adhesions can be a very complicated procedure. In the hands of an unexperienced surgeon, it can result in injury to surrounding organs and a higher risk of conversion to open surgery. Laparoscopic resection of adhesions is the preferred method because it is safer and leads to less pain and faster recovery for the patient. Patients with severe endometriosis should seek care from a surgeon that is experienced in advanced laparoscopic procedures. Gentle handling of the tissue, minimal blood loss, and minimally invasive surgery decrease the risk of adhesion formation.
At CIGC, we perform minimally invasive resection of pelvic adhesions using the DualPortGYN technique. This approach uses only two 5 MM incisions and recovery time is 1 week. All procedures are performed in outpatient settings, and robotics are never used.
To schedule an appointment and get an evaluation with a CIGC specialist, call 888-SURGERY or contact us online. The DualPortGYN technique was developed by Dr. Paul MacKoul and Dr. Natalya Danilyants and has been successfully applied to thousands of GYN procedures.
The Center for Innovative GYN Care has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC for minimally invasive GYN surgery through our travel program.
Many of our patients travel from out-of-town and from out-of-country for advanced minimally invasive GYN surgery at CIGC. Women who don’t have minimally invasive treatment options for their GYN condition closer to home can now benefit from CIGC’s groundbreaking techniques through our travel program. Innovative procedures like DualPortGYN and LAAM were developed by Paul MacKoul and Natalya Danilyants to improve surgical outcomes for patients and to help them recover faster.
GYN surgery for complex conditions like large fibroids and extensive endometriosis is now possible with only 2 small incisions and recovery in less than 2 weeks. Many times women are recommended open or robotic surgery and this is not longer necessary with advanced laparoscopic techniques.
We want to make traveling for GYN surgery from long distances as seamless as possible. Read about CIGC’s travel program and contact us online or at 888-SURGERY to book an appointment. CIGC has offices in Rockville, MD, Annapolis, MD and Reston VA.
Many CIGC patients struggling to conceive have found that GYN surgery for conditions like fibroids or endometriosis can often clear the path to motherhood. Fibroids affect up to 80% of women and they can interfere with a woman’s ability to conceive and carry to term. Endometriosis affects more than 5 million women in the U.S. and it is the leading cause of female infertility. Fertility investments can be expensive and it is important to diagnose and treat GYN conditions early in order to prevent future damage.
A common approach to managing fibroids is the “watch and wait method. This is in fact an outdated philosophy as letting fibroids grow can increases the risks of miscarriages and infertility as well as severe GYN symptoms like abnormal bleeding, pelvic pain, bloating and uterine distortion. Large fibroids can even put women at risk for a hysterectomy.
The location of the fibroid, and not its size, is the key factor when it comes to fertility. Fibroids growing within the uterine lining, or developing within the muscle, can distort the uterine cavity. The result is often difficulty conceiving and a higher risk of miscarriage.
Current advancements in minimally invasive GYN surgery make it possible to safely remove fibroids with only 2 small incisions and repair the uterus by hand to ensure it heals properly for future fertility. The innovative LAAM technique was developed at CIGC by surgical specialists Paul MacKoul MD and Natalya Danilyants MD.
Find out more about the connection between fibroids and fertility and the risks of delaying fibroid treatment in Dr. MacKoul’s recent Tumblr blog: Letting Fibroids Grow Can Lead To Infertility.
CIGC patients have kindly agreed to share stories of their improved lives after minimally invasive GYN surgery. We often see women dealing with pain & discomfort from GYN conditions, who have tried everything and have had multiple failed surgeries before coming to CIGC. After being exposed to robotics and open surgery, the idea that a minimally invasive approach is possible can be eye-opening.
Seeing women like Heidi, Helene, Emily, and Ljubica share their stories with the world can empower other women to ask better questions, and not settle for living a life in pain or unable to conceive.
