The surgeons at The Center for Innovative GYN Care (CIGC) are board-certified, fellowship trained, laparoscopic surgical specialists who developed the DualPortGYN and LAAM techniques — revolutionary approaches to minimally invasive laparoscopic GYN surgery.
Our goal is to educate both patients and doctors who may not be aware of the DualPortGYN and LAAM innovations, and to help improve women’s surgical options by spreading the knowledge about their considerable benefits.
Q: Why did you see a critical need to improve upon existing laparoscopic surgical methods?
A: (CIGC) We saw 4 distinct limitations with existing standard and robotic minimally invasive GYN surgeries. After identifying these major drawbacks to the current methods, we remained passionate about bringing a more elegant and streamlined approach to minimally invasive GYN surgery, so patients receive the highest level of care possible. We made it our mission to innovate surgical solutions to resolve these problems through the development of new methods.
SEEING ANATOMICAL STRUCTURES
PROBLEM: Standard laparoscopic procedures and robotic procedures both use an approach to surgery that does NOT clearly identify the anatomy. In many ways, these approaches are “blind”- this means that vital structures that are not seen could be injured during surgery. Structures such as the ureter – the tube that drains urine from the kidney to the bladder, and the large vessels of the pelvis are not identified.
SOLUTION: The best surgical techniques always identify anatomy to avoid injury to vital structures. DualPortGYN uses a technique called “retroperitoneal dissection” that allows for complete identification of the anatomy of the pelvis to dramatically decrease injury and complications to the ureter, bladder, bowel, and large vessels.
PROBLEM: Another flaw of standard and robotic approaches is controlling blood loss.
SOLUTION: DualPortGYN & LAAM procedures actually control the blood flow of the uterine artery at a point, which is safer, and controls bleeding far better than the standard or robotic approach. This allows CIGC procedures to be used for patients who would otherwise have to face an open surgery. Large uteri and fibroids can be removed safely and easily.
LARGE AND EXCESSIVE INCISIONS
PROBLEM 1: Robotic and standard GYN surgeries are using far too many unnecessary incisions with greater incision size. These factors make for longer and more painful recovery. Robotic incisions range from 4-5 incisions and standard range from 3-5 incisions.
SOLUTION 1: DuaPortGYN uses only two 5 mm incisions, each about ¼ of an inch in size, to complete all surgical procedures. The total length of these incisions combined is about one half of an inch. The result is a speedier and less painful recovery.
PROBLEM 2: Robotic procedures are placing incisions in areas with greater risk for complications.
SOLUTION 2: The two incisions used during a DualPortGYN surgery are placed at the belly button and the bikini line, the most optimal for incisions in GYN surgery. Using the mid-line is safer for the patient and offers a better view for our techniques.
PROBLEM 3: Unnecessary incisions result in avoidable visible scarring, and less than desirable cosmetic outcomes.
SOLUTION 3: DualPortGYN has the best cosmetic profile of any minimally invasive laparoscopic GYN surgery. Only two tiny 5mm incisions result in what is called a “scarless” surgery. The scars are in most cases not even seen one month after the procedure.
PROBLEM: Power morcellation is still used extensively for standard and robotic approaches.This technique is responsible for a higher risk of spreading cancerous fibroids as well as the use of a larger incision and longer surgical times. The FDA has placed a temporary ban on power morcellators.
SOLUTION: Power morcellation is not necessary nor is it ever used for DualPortGYN or LAAM procedures.
DualPortGYN can remove fibroids through the vaginal defect, thereby eliminating the use of the morcellator. This greatly decreases spread of cancerous fibroids, as well as decreasing the incision size, pain, and recovery.
LAAM procedures for fibroid removal only use a very small incision at the bikini line with special techniques to remove all the fibroids from the uterus, thereby sparing the uterus but keeping pain and recovery to a minimum.
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Get to know Paul Mackoul MD and Natalya Danilyants MD.