In the field of infertility and gynecology, some patients require surgical procedure. In the past, in every surgery we need to open the abdomen with a single large incision. At the present time we can offer M.I.S. as an alternative to open surgery, where we perform small little incisions in the abdomen and we can watch the operating field on a monitor.
The advantage of M.I.S. is a less chance of infection, less blood loss, less hospital stay or even outpatient surgery, as well a better and faster recovery.
It is true that In Vitro Fertilization (IVF) many times it is a shortcut to avoid surgery in quite a few cases of infertility where the fallopian tubes are damaged.
We have the chance to offer to our patients laparoscopic surgery as well as robotic assisted laparoscopy (RSL). Robotic assisted surgery is one of the latest techniques, it is very precise, offers larger magnification and 3-D view compared with a standard laparosopic surgery.
Robotic Assisted Surgery with surgeon sitting at the robotic console and the robotic arms over the patient surgical field.
Any M.I.S. needs to be performed in an operating room under general anesthesia. We also insuflate air into the abdomen to allow the visualization of the abdominal and pelvic organs as well as introduction of all the skinny instruments needed.
In Gynecology/ Infertility we perform M.I.S. for:
-Removal of scar tissue
-Removal of fallopian tubes, ovaries or uterus
Regarding the risk of M.I.S., they are similiar and less compared to any other surgery. The risks are from anesthesia, infection, bleeding and damage of neighbor organs.
As a general concept a conservative gynecological surgeon and a fertility doctor we have surgeries in our tool box, but we try to be as conservative as we can, always trying to offer other options as far as they are available.
Daniel A. Rostein M.D., FACOG
Assistant Professor Loyola Medical School