Women Must Become Empowered To Ask For Minimally Invasive Gynecologic Surgery

Armen Hareyan's picture
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Gynecologic Surgery

Endoscopic techniques are transforming the practice of surgery, yet their adoption in certain specialties, particularly gynecology, lags far behind that of other specialties. For example, laparoscopic surgery for gall bladder removal reached an 80% adoption rate over the ten years since it was introduced, while laparoscopic hysterectomy is still used for less than 15% of the 600,000 hysterectomies annually performed in the United States. Reasons for the discrepancy include lack of patient education, lack of physician training, reimbursement issues, and reluctance of women to question their doctors, said experts at the 36th Annual Global Congress of Minimally Invasive Gynecology.

"Historically the AAGL has been devoted to introducing and testing new surgical techniques and educating surgeons how to perform endoscopic and laparoscopic procedures," said Charles E. Miller, MD, President-Elect of AAGL. "Today we are broadening our mission to include education and empowerment of our patients."

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Highlighted at the meeting were new in-office procedures that replace the need for a woman to spend hours in a hospital operating room; the coming transformation of surgery through the use of robotics; and the miniaturization of surgical techniques in general as the medical profession leverages technological advances made by NASA, the military and the communications industry.

Procedures Move from the Hospital to the Office

Keith Isaacson, MD of Harvard Medical School and a surgeon at Newton Wellesley Hospital, MA, described three examples of procedures that once required several hours in an operating room, general anesthesia and days of recovery, but now can be done safely, effectively and without anesthesia in the physician's office: hysteroscopy; permanent sterilization; and endometrial ablation.

Hysteroscopy is a diagnostic technique in which the physician uses a miniature "telescope" to view the inside of the uterus, frequently used to diagnose the cause of abnormal uterine bleeding (AUB), a condition

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