Minimally Invasive Gynecologic Surgery

The word “surgery” often conjures up thoughts of severe pain and lengthy recovery, keeping you from your day-to-day activities. While traditional surgery that involves large abdominal incisions was once the only option for a variety of gynecologic diagnoses, the University of Michigan can offer a minimally invasive approach– including robotic surgery – for most gynecologic conditions.  Minimally invasive surgery means less postoperative pain, less risk of wound infection, less blood loss, less scarring and faster recovery time.  Most patients can go home with their family within 24 hours of their surgery.

The University of Michigan’s Minimally Invasive Gynecologic Surgery (MIGS) Program is proud to be a national leader in minimally invasive surgery options, including robot-assisted laparoscopy, for benign gynecologic conditions.  Our team offers a broad range of surgical and medical treatment options for women suffering from uterine fibroids, endometriosis, abnormal uterine bleeding, ovarian cysts, and chronic pelvic pain.

When considering treatment options, U-M offers patients the option of advanced laparoscopic and hysteroscopic surgery, as well as complex abdominal and vaginal surgery.  The University of Michigan is one of the first institutions in the nation where robotic procedures in gynecology were performed, and continues to be a leader in this field with over 10 years of experience in gynecologic robotic surgery.  We have performed hundreds of gynecologic procedures safely and efficiently with the use of robot-assisted laparoscopy.  In the area of benign gynecological surgery, U-M Von Voigtlander Women’s Hospital is a leader in robotic myomectomy and robotic hysterectomy — with extensive experience in using this technology to address complex pathology such as large uterine fibroids, advanced endometriosis, and severe pelvic adhesive disease.

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Why choose our team?

Our team of experts will evaluate each patient individually and discuss the medical and surgical treatment options that best suit her needs.  Our physicians are conservative in their approach to benign (non-cancerous) gynecologic conditions, and only consider surgical options when indicated and appropriate.  If surgery is found to be an appropriate option, we can offer a minimally invasive approach to most patients, even when they are told by other physicians that a laparoscopic approach is not possible. 

All of our physicians are fellowship- trained specialists in minimally invasive surgery for benign gynecologic conditions.  This means that all of our doctors have obtained an additional 2 years of specialized surgical training in advanced laparoscopic and minimally invasive surgery techniques.  Our clinical practice is dedicated exclusively to the care of women with complex, benign gynecologic conditions.  As a group, we perform the highest number of and have the greatest experience in minimally invasive surgeries for benign conditions in the region.

Conditions we treat:

  • Uterine fibroids
  • Endometriosis, including advanced stages
  • Abnormal uterine bleeding (Heavy or prolonged bleeding, Irregular bleeding)
  • Benign ovarian cysts or pelvic masses (non-cancerous)
  • Adenomyosis
  • Chronic pelvic pain

Types of Surgical Procedures Routinely Performed:

  • Laparoscopic removal of endometriosis
  • Diagnostic laparoscopy
  • Laparoscopic removal of ovarian cysts
  • Laparoscopic removal of ovaries & fallopian tubes
  • Endometrial ablation
  • Hysteroscopic removal of uterine fibroids or endometrial polyps

Myomectomy is the surgical removal of uterine fibroids without the removal of the uterus. There are several techniques that may be used, and the choice of the technique depends on several issues including the location and size of the fibroids, the number of fibroids as well as the characteristics of the woman.  Surgical approaches to myomectomy include robot-assisted laparoscopic myomectomy, abdominal myomectomy, and hysteroscopic myomectomy.

Hysterectomy is the surgical removal of uterus.  Although ovaries can also be removed at the time of hysterectomy, this is not required or recommended for all women.  The decision to remove or keep the ovaries should be made on an individual basis. There are two categories of hysterectomy:

    • Total hysterectomy is removal of the entire uterus, including the cervix (the lower part of the uterus).  Surgical approaches to total hysterectomy include vaginal hysterectomy, laparoscopic hysterectomy, robot-assisted laparoscopic hysterectomy, and abdominal hysterectomy.

 

  • Supra-cervical hysterectomy is removal of the upper part of the uterus, but not the cervix. This type of surgery is not recommended for women with a history of an abnormal Pap smear or certain types of pelvic pain. Up to 5-10% of women may continue to have chronic cyclic bleeding after surgery, similar to a period. It was previously thought that a supra-cervical hysterectomy would preserve sexual function better than a total hysterectomy, but research does not support this theory. Benefits to supra-cervical hysterectomy include slightly shorter recovery time.  U-M offers laparoscopic and robot-assited laparascopic approaches to supra-cervical hysterectomy.

Additional specialty services provided include:

An office-based hysteroscopy clinic is available to perform diagnostic hysteroscopy, saline sonography, removal of small endometrial or cervical polyps, and retrieval of retained intrauterine devices (IUD).  Additional services include removal of small endometrial polyps and  endometrial  ablations.

The University of Michigan Endometriosis Center offers state-of-the art medical and surgical treatment options to women with endometriosis, including those with advanced endometriosis.  Our extensive experience in minimally invasive and robotic surgery allows us to offer most women with advanced endometriosis a laparoscopic approach if surgery is thought to be necessary.

The Chronic Pelvic Pain Consultative Clinic offers consultative services to women with chronic pelvic pain, including those with painful menstrual periods, undiagnosed chronic pelvic pain, and pain after hysterectomy.  Our multidisciplinary team of physicians, nurse practitioner, advanced-care nurses, and physical therapists are happy to work with the referring physician to evaluate each patient individually and make treatment recommendations that best suit her unique needs.  Please note that this clinic is not a pain management clinic, and does not provide long-term management of prescription narcotic/pain medications.  We also do not provide medical disability for non-surgical patients.  Our goal is to work with patients and their primary care physician to create an appropriate long-term treatment plan.  Once we have established an appropriate treatment plan and/or surgical intervention, patients are able to continue their care under the supervision of their local physician.

Contact Information:

Von Voigtlander Women's Hospital
            1540 E. Hospital Drive Floor 9
            Ann Arbor MI 48109
            Map and General Information
            Call Toll-Free 1-855-58WOMAN
            1-855-589-6626