Innovation in Gynecology: Beyond The Stirrups Part 1
(The first in a three-part series about the disparities in advancements for women’s health.)
Despite more than 150 years of medical advancements since the development of what women know today as the speculum (a tool that retains the same design and purpose since the mid-1800s), many of the methods that continue to be used to examine and treat women for gynecological conditions have seen little advancement. Innovations that have been made are not widely used in part due to archaic attitudes to women’s health.
In the United States, arguably one of the most medically advanced nations in the world where laparoscopic surgeons have shown superior outcomes using smaller incisions for complicated conditions, more than 50% of the ~400,000 hysterectomies performed annually are still performed as open surgery. Using 6-8 inch vertical or horizontal incisions that tear through a woman’s abdominal muscles, open surgical patients have an increased risk of suffering muscle weakness, scarring on and within the abdomen which can cause additional complications well after the surgery, and take weeks to months for recovery.
Laparoscopy was first performed over 100 years ago. Advancements in minimally invasive techniques today are light years ahead of where they were, even 10 years ago. There is little need to perform open GYN procedures other than financial gain. However, adoption of new techniques requires extensive education, training and honing skills. In the case of laparoscopic surgery, becoming a high-level specialist proficient in advanced techniques can only come from intense training and a commitment to excellent patient care.
The fact that patients who present with complex GYN conditions are still told that open surgery is their only option, frequently performed by surgeons who are not trained on the latest techniques shows a systemic reluctance to advance women’s health care options.
Specialists who understand the long-view of improved patient care can encourage systemic changes away from open procedures. Recognizing the need for better outcomes for women with complex GYN conditions led to the development of the DualPortGYN® technique and LAAM® for fertility technique. The fellowship-trained laparoscopic specialists who founded The Center for Innovative GYN Care® (CIGC®) developed these techniques after discovering new ways to implement advanced techniques for cancer patients to improve upon all GYN surgical patient outcomes. All CIGC-trained surgeons are trained on these exclusive techniques that make it possible to treat each patient based on her specific needs.
“Individualized laparoscopic treatment for women is possible,” said Paul MacKoul, MD. “When women are able to choose a surgeon who has advanced training and extensive surgical experience in minimally invasive GYN techniques, rates of surgical success are high. The combination of skill and technique means endometriosis or pelvic adhesions, conditions that can only be diagnosed through laparoscopic surgery, can be addressed simultaneously with a scheduled hysterectomy or myomectomy. For a patient who may have faced multiple surgeries by multiple doctors, this changes their overall outcome. That is important for recovery.”
“Too many women are told by their doctors to wait to treat conditions like fibroids or endometriosis, often due to lack of laparoscopic training,” said Natalya Danilyants, MD. “Lack of surgical skill should not be an indicator of a patient’s candidacy for a minimally invasive procedure. If a surgeon can only perform an open procedure for a complex GYN condition, it is important for the patient to get a second opinion. A woman’s overall health can be affected by more invasive procedures that increase scarring and have higher risk of complications including blood loss, without the confidence that the procedure will also be thorough.”
Read the full article | Challenging Systemic Attitudes in the Medical Community Toward Innovations In Women’s Health