Minimally Invasive Gynecologic Surgery

A Collaborative, Patient-Centered Philosophy

The arc of a woman’s life is marked by profound physiological changes from puberty to menopause. From time to time, these changes require expertise beyond routine gynecologic care.

At The GW Medical Faculty Associates, our gynecologic specialists have advanced training in Minimally Invasive Gynecologic Surgery. They are high volume surgeons focusing solely on advanced surgical techniques to manage complex gynecologic conditions. Our surgeons pursue a team-based approach to care — coordinating with specialists from urology, fertility and colorectal surgery to ensure patient concerns are heard, understood, and treated appropriately.

We begin with a careful assessment conducted in our offices supported by diagnostic technologies such as:

  • bedside ultrasound
  • flexible and rigid hysteroscopy
  • saline-infusion ultrasonography
  • fluoroscopic urodynamic testing
  • flexible cystoscopy
  • hysterosalpingography

Comprehensive evaluation helps to identify women who are candidates for in-office treatment such as hysteroscopic sterilization, polypectomy, and endometrial ablation.

When surgery is recommended, our doctors are dedicated to pursuing the advantages offered through minimally invasive gynecologic surgery. That approach commonly results in reduced pain, speedier recovery, and briefer hospital stays — when hospitalization is warranted at all. A majority of our patients are treated by laparoscopy or hysteroscopy.

Our Services

Endometriosis Excision

Endometriosis is a painful and chronic disease of pre-menopausal women. Extensive disease, scarring, and pain can prompt a series of surgeries and compromised quality of life. Our gynecologic surgeons have the expertise to manage the most complex cases, including involvement of the bowel, bladder, and extra pelvic endometriosis. They use a multidisciplinary approach collaborating with specialties such as colorectal surgery, urology, thoracic surgery, pelvic floor physical therapy, and chronic pain specialists.

Myomectomy

There is no single recommended approach to dealing with uterine fibroids. When medications have failed to resolve a woman’s heavy or prolonged periods, pain, urinary incontinence or constipation, she may be a candidate for myomectomy. A thorough exam using flexible hysteroscopy, saline infusion sonography or MRI will helps establish an appropriate plan.

Most myomectomies can be performed minimally invasively using hysteroscopic, laparoscopic, robotic, and mini-laparotomic techniques.

Our surgeons are nationally recognized for their expertise in laparoscopic suturing. They understand the importance of careful uterine repair to help ensure successful pregnancy after treatment.

Fibroid radiofrequency ablation (Acessa)

Laparoscopic and ultrasound guided radiofrequency ablation of fibroids was recently FDA approved for the management of uterine fibroids as an alternative to hysterectomy and myomectomy. A thorough exam using flexible hysteroscopy, saline infusion sonography or MRI will help establish candidacy for this option.

Hysterectomy

A majority of patients are treated either laparoscopically or vaginally. Laparoscopic removal of even the largest uterus is completed by blending vaginal surgery, robot assisted laparoscopy, and more common two-to four-incision laparoscopy.

Alternatives to Hysterectomy

No two patients are the same. Our physicians emphasize exploring all reasonable conservative options to manage symptoms — including hormone treatments to control bleeding and pain, progesterone IUDs, office--based endometrial ablation, fertility sparing endometriosis excision, myomectomy, and radiofrequency ablation of uterine fibroids.

Asherman’s Syndrome

Prior surgery or infection can cause uterine scarring which compromises a woman’s ability to conceive. Our physicians are experienced in releasing these adhesions to restore fertility and can perform these procedures both in the office and in a hospital setting.

Surgical Approaches

Single-Incision, Two-Port, and Traditional Laparoscopy

Laparoscopy is the use of small punctures in the abdomen to perform a surgery rather than a large, open incision. This allows procedures to be done with less complications, a same-day discharge, and a faster recovery. Almost every patient is a candidate for laparoscopy and we encourage patients to seek us out for second opinions if they have been told otherwise. Every surgery is customized to each patient's anatomy and can often be done through one or two small punctures.

Advanced Robotic Surgery

Robotic surgery can enhance precision and permit minimally invasive approaches for women whose conditions might have previously been addressed through traditional, open surgery alone. We have been pioneers with reduced-port and single-port robotic surgery and are nationally recognized for our skill and efficiency in this modality of laparoscopy.

Vaginal Surgery

We believe there are times when a vaginal approach to surgery will lead to the safest and quickest recovery. We are happy to review all of your options, including the pros/cons of each approach.

Why Choose Our Team

Expertise. Our physicians are leaders in the use of the advanced techniques. When conservative treatments have failed to deliver the desired results and surgery is recommended, our surgeons offer minimally invasive surgery, performed through an incision in the vagina or through small abdominal incisions or even a single incision hidden in the belly button. Some patients may be candidates for robotic surgery.

Experience. Our gynecologic surgeons are subspecialty trained and perform hundreds of procedures every year, including robotic hysterectomies.

Collaborative approach. Multispecialty teams draw from expertise in gynecology, urology, fertility and colorectal specialties to determine appropriate approaches to treatment.

Fellowship Information

Our Fellowship in Minimally-Invasive Gynecologic Surgery was created in 2009 and is a 2-year training program one completes after finishing a 4-year residency in Obstetrics & Gynecology. We are fully accredited by the AAGL and have one fellow per class. The concept of the fellowship was borne out of recognition that most graduating residents are not prepared to offer modern techniques of advanced laparoscopic, robotic, and hysteroscopic surgery. Additionally, the fellowship is geared to foster an academic scientist who will elevate the surgical care of women and advance the field by conducting research, becoming educators, and serving as community consultants.

Meet our fellows:

  • Whitney Barnes, MD, MPH (2019-2021)
  • Danilo Acosta-Diaz, MD (2020-2022)

https://www.aagl.org/service/fellowships/

AAGL Center of Excellence logo

 

AAGL Center of Excellence Award