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Less is More

NEW AND SAFER MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES

Rachel Corey, 38, liberally uses the word “amazing” to describe her life as full-time mom to two active children, 2-year old Sofiah and 12-year old James. Her favorite adjective is itself amazing, since barely a year ago her word of choice was “miserable.”

Shortly after her daughter’s birth, Ms. Corey, a resident of Binghamton, began suffering heavy menses. By 2013, the problem had escalated and she spent many days either dreading her period’s onset or in bed waiting for it to end. “One night the bleeding was so bad I ended up in the UHS Wilson ER. Something was very wrong,” Ms. Corey says.

The next morning, she saw her OB/GYN, Dhruv Agneshwar, MD, FACOG, of Santé Healthcare, a practicing OB/GYN at UHS and director of minimally invasive gynecologic surgery at UHS Wilson Medical Center. Tests showed that Ms. Corey had an enlarged uterus with uterine fibroids — noncancerous tumors in the uterine wall that affect as many as 8 in 10 women by the age of 50. Dr. Agneshwar recommended a laparoscopic hysterectomy to remove the uterus.

“I had the surgery on a Monday, went home the same day, and was up and around on Tuesday,” Ms. Corey recalls. “I may have neglected to tell my husband how amazing I felt until Wednesday.”

Moving Forward

Ms. Corey’s laparoscopic hysterectomy falls into a category of sophisticated procedures called minimally invasive surgery (MIS). These procedures are performed through tiny half-inch incisions, rather than one large opening, and deliver significant patient benefits, including minimizing blood loss, post-operative pain and complications, and hastening recovery times. Just as Ms. Corey did, patients typically return home within 23 hours or less and are back to a normal routine within two weeks.

As a leader in state-of-the-art minimally invasive gynecologic procedures, UHS is able to offer women a range of techniques, with the final choice made between patient and surgeon on a case-by-case basis. For example, UHS offers three successful approaches to minimally invasive hysterectomy:

  • A laparoscopic hysterectomy is performed by inserting a laparoscope (a tube with a camera at the end) and surgical tools into the patient through tiny incisions in the abdomen. Images from the laparoscope are projected onto a screen in the operating room, giving the surgeon a clear view of the uterus, which is removed through a tiny abdominal incision.
  • A vaginal hysterectomy is performed entirely through the vagina. The surgeon makes a tiny incision in the vagina, inserts the surgical instruments, and removes the uterus through the vaginal cut.
  • A laparoscopic-assisted vaginal hysterectomy involves inserting a laparoscope through the vaginal incision to view internal organs on screen.

“Technology is moving us forward in a positive direction that is much better for the patient, and this progress gives us MIS options to treat different women with different needs. It’s to the point where we treat few gynecologic issues with a more traumatic open surgery,” Dr. Agneshwar says.

The Team Approach

In order to offer gynecologic patients a range of minimally invasive options, UHS brought an unparalleled surgical team on board. “It’s difficult to achieve expertise in everything — for example both vaginal hysterectomy and laparoscopic hysterectomy,” explains Nancy Shumeyko, MD, gynecologist with the UHS Medical Group. “It takes a team, with each surgeon an experienced specialist in his or her respective discipline. In this way we can identify the surgical route that most safely and cost-effectively serves each woman.”

With this team in place, UHS is able to offer advanced minimally invasive gynecologic treatments for many conditions and problems, including:

  • Ovarian cysts
  • Pelvic pain
  • Permanent birth control
  • Uterine fibroids
  • Abnormal uterine bleeding
  • Ectopic pregnancy
  • Urinary incontinence

Often these procedures are performed in the UHS Ambulatory Surgery Center at Wilson Place across from UHS Wilson Medical Center in Johnson City, where patients receive same-day surgical care without hospitalization. The ambulatory surgery center features four surgical suites and 16 bays for pre-operative and post-operative care.

Experience Matters

While minimally invasive procedures are considerably easier on the patient, it’s a different story for the surgeon, explains Dr. Shumeyko. “These procedures have a learning curve, since the surgeon can’t work through a big, open cut. So you really want a surgeon with a lot of experience.”

An unprecedented experience is precisely what UHS’s world-class surgeons bring to the patient. “Because of our team and our reputation, we perform more minimally invasive gynecologic procedures than any other healthcare provider in the region,” Dr. Agneshwar says. “Our experience allows us to take complicated cases and give more women the chance to live better lives.”

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MAXIMUM HONORS

 

The American Institute of Minimally Invasive Surgery (AIMIS) recently designated UHS Wilson Medical Center as a Gynecological Surgery Center of Excellence. “This recognition means a great deal — especially to our patients,” says Dr. Agneshwar. “To achieve this award meant collecting a lot of data that shows our higher level of experience and success. It says we’re an organization where women can feel safe and know that only a highly experienced surgeon performs any minimally invasive gynecological procedure at UHS.” The AIMIS designation also recognizes UHS’ focus on advanced solutions to convert open surgeries to minimally invasive approaches that offer patients shorter hospitalizations and faster returns to normal activities. Gynecology at UHS was also recognized as “high performing” by U.S. News & World Report in its annual listing of the nation’s top hospitals. Patient safety, nursing, patient volume and advanced technologies were among the factors the magazine examined in determining its rankings.