Providers at Metro OBGYN are known for our surgical and technical excellence and our commitment to bringing the latest proven therapies to our patients.

Many physicians refer patients to us because of our expertise in surgical treatments.

If you're considering a complex procedure, be sure to contact us to discuss your treatment options.

 

Metro OBGYN Surgical Treatements

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LEEP

Loop electrosurgical excision procedure (LEEP) is a procedure performed to treat abnormal cervical cells. It is a biopsy that removes the abnormal cells and allows a pathologist to examine them. Typically, this procedure is performed in our office procedure room or in a same-day surgery center.


The purpose of this procedure is to remove abnormal cervical cells. This is done by passing electric current through a thin wire loop. This cuts away a small piece of the cervix and helps minimize bleeding at the same time. After the procedure is completed a thick brown paste is often applied to the cervix to help stop bleeding.

This procedure typically takes less than 30 minutes. It is frequently performed with conscious sedation and occasionally general anesthesia.

The benefits of the procedure include providing the pathologist with tissue to examine and properly diagnose abnormal cervical cells as well as removing abnormal cells before they turn into cancer.

Occasionally, all abnormal cells are not removed and you will need a second procedure. The risks include bleeding, infection, scarring and need for further surgery. Additionally, there is an increased risk of preterm rupture of membranes and preterm birth in future pregnancies.

Following the procedure, you will have an abnormal discharge (brown/black) that is a result of the paste applied to the cervix at the end of the procedure. Additionally, you may have mild cramping and some bleeding. It will take a few weeks for the cervix to heal. During this time you should not put anything in the vagina. You should avoiding tampons, douching and intercourse until you have seen your doctor.

If you have heavy bleeding that requires more then 2 pads an hour or a fever over a 100.4F you should contact your doctor.

Dilation and Curettage (D&C)

A D&C is a surgical procedure that is performed to diagnose and treat conditions like abnormal menstrual bleeding, postmenopausal bleeding or a miscarriage. During the D&C tissue is obtained that can be examined to see if abnormal cells are present. It also can help stop abnormal bleeding.


The procedure may be performed in our office procedure room, in the same-day surgery center or in the hospital. To perform the procedure the cervix is slowly dilated. An instrument is then inserted into the uterus (either a curette or a suction tip) and the lining of the uterus is removed.

The risks of the procedure include bleeding, infection, scarring and perforation of the uterus with an instrument.

You will go home the same day as surgery. You may experience cramping or light vaginal bleeding. If you experience heavy vaginal bleeding (more then 2 pads an hour), abdominal pain or a fever that is greater than 100.4F contact your doctor immediately. You should be able to resume your normal activities in 1-2 days.

Hysteroscopy

This is a procedure that allows your doctor to visualize the inside of the uterus to help evaluate causes of abnormal menstrual bleeding, diagnose the cause of repeated miscarriage, perform sterilization or locate an intrauterine device.


The procedure is frequently performed with conscious sedation and occasionally general anesthesia. It is performed in our office procedure room or a same-day surgery center. Occasionally, it is done in the hospital if you have other medical conditions. The procedure is performed by dilating the cervix and then inserting a thin camera through the cervix into the uterus. A clear fluid, most frequently saline (or salt water) is used to fill up the cavity of the uterus to allow for better visualization.

The procedure typically takes less than 30 minutes. You will go home the same day as surgery and usually can resume your normal activities within 1-2 days. The risks include bleeding, infection and uterine perforation with an instrument or the camera. Additionally, there is a small risk if your body absorbs too much fluid.

You may experience mild cramping or light vaginal bleeding. If you have significant abdominal cramps or a fever greater then 100.4F call your doctor immediately.

Laparoscopy

Laparoscopy is a surgery performed to look inside the abdomen and pelvis. This may be performed to evaluate pelvic pain, examine and treat an ovarian cyst, treat an ectopic pregnancy, perform sterilization or evaluate possible causes of infertility.


The procedure is usually performed at a same-day surgery center or in the hospital depending on the indication for your surgery as well as your other medical conditions. Often times you will go home the same day. General anesthesia is used for laparoscopy.

To perform the procedure two to three small incisions are made in the abdomen and a slender camera is inserted in the incision near your belly button. Instruments are inserted through the other incisions allowing your doctor to examine the abdomen and pelvis and perform any procedure that is needed.

he benefits of the surgery include a shorter and less painful recovery then a procedure with a larger open incision. Also, performing a procedure where we look into the abdomen frequently gives us much better information and answers then we are able to get with less invasive techniques like an ultrasound. The risks of the procedure include bleeding, infection, damage to pelvic organs and need for further surgery.

Following the procedure, you may experience nausea, emesis or abdominal pain. Your doctor will let you know when you can resume your normal activities. But for minor procedures, you can typically resume most activities within a few days.

If you have a fever, significant abdominal pain, redness, swelling or discharge from your incision notify your doctor immediately.

Tubal Ligation

A tubal ligation is a form of permanent birth control where the fallopian tubes are blocked using various methods. Blocking the fallopian tube prevents the sperm from meeting the egg. This is the most common form of birth control worldwide.


A tubal ligation can be performed two ways – a post partum tubal ligation or a laparoscopic tubal ligation

A postpartum tubal ligation is frequently performed the day after a vaginal delivery. A small incision is made under the belly button. The fallopian tube is grasped and the tube is cut and tied. This is repeated on the other tube.

Laparoscopic tubal ligation is performed by making two or three small incisions in your abdomen. A camera is inserted into the abdomen as well as an instrument close to the fallopian tube. The tube is then blocked with a clip, a band or electric current. The laparoscopic tubal ligation is very effective. Depending on how the tubes are closed 18-37 pregnancies occurred in 1,000 women within 10 years of the procedure.

The benefits of a laproscopic tubal ligation are that it is effective permanent birth control. The procedure typically takes less than an hour and you go home the same day. Additionally, the procedure works immediately.

The risks of a laproscopic tubal ligation include the risks of general anesthesia, bleeding, infection as well as risks of injury to pelvic organs including the bowel, and bladder. Finally, although pregnancy is rare, if you do become pregnant there is a higher chance of an ectopic pregnancy which can be a surgical emergency.

After the procedure you may experience nausea, abdominal cramps and a sore throat. Additionally, it is not unusual to have shoulder pain – this is caused by gas that is used to insufflate the abdomen.

Essure® Permanent Birth Control

Essure is a surgical procedure performed for permanent birth control. To perform this procedure a camera is placed through the vagina and cervix and into the uterus. With the help of the camera, implants are placed into the fallopian tubes that facilitate tissue growth that blocks the tubes.


This procedure does not work immediately. You must wait 3 months for the scar tissue to block the tubes. After 3 months an X-ray study called a hysterosalpingography (HSG) is performed to confirm the tubes are blocked. Once you have confirmed the tubes are blocked the Essure is a very effective form of birth control. 1 in 1,000 women become pregnant within 5 years of having the procedure.

This procedure is often performed in our office procedure room or in a same-day surgery center. It may be performed in the hospital if you have other medical conditions.

The main benefit of the procedure is obtaining permanent birth control with no abdominal incisions.

The risks of the procedure include bleeding, infection, injury to the uterus or fallopian tube as well as the possibility the device could move out of the tube. If this occurs you may need a surgery to remove it from the abdomen. Additionally, pregnancy is rare but if it does occur there is a higher chance it would occur in the tube (ectopic pregnancy). An ectopic pregnancy can be a medical emergency. Finally, in rare cases women have had pain and needed further surgery.

Endometrial Ablation

Endometrial ablation is a procedure performed to treat heavy or abnormal menstrual bleeding. In some women, the bleeding becomes lighter or normal and in others, it may stop completely. If bleeding is not improved you may need to have further surgical management.


Typically, this procedure is performed in our office procedure room or in a same-day surgery center. Occasionally, this is performed in the hospital if you have other medical conditions.

The purpose of this procedure is to destroy the lining of the uterus that builds up each month known as the endometrium. This can be achieved by various methods that include heated fluids, microwave energy, high-energy radiofrequencies, electrosurgery or freezing. Your physician will choose the method that is best for you.

This procedure typically takes less than 30 minutes. It frequently is scheduled as a hysteroscopy, dilation and curettage and endometrial ablation. This means the physician will look inside the uterine cavity with a camera and perform a gentle scraping of the uterus prior to performing the ablation. Thinning the lining of the uterus often allows for a more effective destruction of the uterine lining.

The benefits of this procedure include an improvement in menstrual bleeding, short recovery time, no abdominal incisions and high patient satisfaction. The risks of procedure include bleeding, infection, and perforation of the uterine wall with a surgical instrument and heat damage to nearby organs. Additionally, some women may go onto have a hysterectomy. Getting pregnant after an endometrial ablation can be very serious for the mom and baby. A tubal ligation can be performed at the time of endometrial ablation to ensure you do not get pregnant.

Following the procedure, you may have abdominal cramping. This is most significant in the first 24 hours. Mild cramps may persist for 1-2 weeks. Additionally, you may experience vaginal discharge for a few weeks after the procedure and frequent urination immediately after the procedure.

Hysterectomy

A hysterectomy is a surgery that removes the uterus. This is a very common procedure and is done to treat many conditions including abnormal uterine bleeding, uterine fibroids, endometriosis, uterine prolapse, pelvic pain and cancer. 


There are various types of hysterectomies that can be performed:

1. Vaginal hysterectomy – The uterus is removed through the vagina. There are no abdominal incisions.

2. Laparoscopic-assisted vaginal hysterectomy – Three small incisions are made in the abdomen and instruments are used to help remove the uterus through the vagina.

3. Robotic-assisted laparoscopic hysterectomy – A robot is attached to the laparoscope to assist with surgery.

4. Abdominal hysterectomy – The uterus is removed through an abdominal incision.

5. Supracervical hysterectomy – The uterus is removed through an abdominal incision by either cutting the uterus into small pieces or removing it intact through a slightly larger incision. The cervix is left in place. This is typically performed if the hysterectomy is performed for uterine prolapse.

These are the various ways to perform a hysterectomy. Your doctor will talk with you to discuss what type of procedure is best for you.

Additional procedures performed at the time of a hysterectomy may include a salpingectomy which is removing the fallopian tubes or an oophorectomy which is removing the ovaries.

The benefits of having a hysterectomy are that it is the definitive treatment for abnormal menstrual bleeding. Additionally, it is a long-term effective treatment for uterine prolapse. The risks of the procedure include bleeding, infection, damage to pelvic organs and need for further surgery.

The type of hysterectomy you have determines how long you will be in the hospital. Frequently women are able to go home the same day of a vaginal hysterectomy, may stay overnight with a robotic-assisted laparoscopic hysterectomy and you may stay 2 to 3 nights after an abdominal hysterectomy. The recovery also depends on the type of surgery you have. You can plan on taking it easy for 1-2 weeks after your surgery and generally women are able to return to work after 3-6 weeks.

Preparing for surgery

Month prior to surgery:

Depending on the surgery and your personal history, we will plan to complete your surgery at the hospital, a same-day surgery center, or in our office procedure room.

Inpatient surgery occurs in the hospital only and will require you staying overnight. Outpatient surgery (ambulatory or same-day surgery) can occur in the hospital, at a same-day surgery center, or in our office procedure room. You will be going home that same day if your condition is stable. You will need someone to drive you home.

You will often need a pre-surgery physical in the 30 days before your surgery. This will include an exam and may also include blood/urine tests, a chest x-ray, and an electrocardiogram (EKG).

Make a list of all medications, vitamins, over-the-counter medications, and herbs or supplements you take. Bring that list to your pre-surgery physical and with you on the day of surgery. Your health care provider will let you know which medications should be discontinued before surgery.

If you take Advil, Ibuprofen, Aspirin or other similar medications for pain relief you should stop taking this medication 10 days prior to your surgery. If you take it for a medical condition - talk to your physician at your pre-surgical physical.

If you smoke, try to stop smoking before your procedure. Smoking makes it harder for wounds to heal, and for the anesthesiologist to help you breathe during your surgery.

If you have diabetes, controlling your blood sugar levels before and after surgery will help you heal.

Days prior to surgery:

***YOU SHOULD HAVE NOTHING TO EAT OR DRINK AFTER MIDNIGHT THE DAY OF SURGERY.

This includes gum, coffee, and water. If you were told to continue taking medications the day of surgery, take them with sips of water.

Do not drink alcohol for 24 hours before surgery.

Depending on your surgery, you may need to complete a bowel preparation. Your doctor will give you instructions and tell you what this entails.