Vaginal access procedures use the natural opening of the vagina to assist with advanced laparoscopic GYN techniques. By using the vaginal opening during procedures such as hysterectomy, removal of pelvic masses or fibroid removal by hysteroscopy, the surgeon limits the size and number of incisions in the abdominal wall. This decreases pain, complications, and recovery time. The following is a list of some of the more common vaginal access procedures performed by CIGC surgeons.
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Vaginal Access Procedures
By using the vaginal opening during procedures such as hysterectomy, removal of pelvic masses or fibroid removal by hysteroscopy, the surgeon limits the size and number of incisions in the abdominal wall. This decreases pain, complications, and recovery time. The following is a list of some of the more common vaginal access procedures performed by CIGC surgeons.
In minimally invasive hysterectomy, the uterus is either removed through the vagina using vaginal debulking techniques, or through an incision in the abdominal wall. Typically, to remove fibroids through the abdominal wall, the incision must be at least 1.5 cm in size, and can become larger if needed. This increases pain and recovery time. By using the natural vaginal opening for removal, the surgeon is not increasing the size or number of incisions in the abdominal wall.
When properly performed, this procedure is safe and effective. CIGC laparoscopic GYN surgeons use this technique extensively to remove very large fibroids. There is no injury to the vagina – the length, width, or integrity of the vagina is not affected. There is no change in intercourse with the use of vaginal debulking for fibroids. Patient satisfaction rates are very high with this approach, with pain minimized and faster recovery than the use of larger abdominal wall incisions.
Vaginal Cuff Closure
Closure of the vaginal cuff after hysterectomy can be accomplished either laparoscopically or vaginally. Many surgeons have difficulty closing the top of the vagina after a hysterectomy through the natural vaginal route, and instead perform the vaginal cuff closure through one of the small abdominal incisions. This approach requires more time and is less effective. In many cases, using the natural opening to perform the vaginal cuff closure results in a safe, efficient, and more effective result. CIGC surgeons use this technique to close the vaginal cuff with excellent results and minimal complications.
Vaginal Removal Of Pelvic Masses
In many cases, removal of a large ovarian mass is very difficult through the abdominal wall, and often a larger incision is required. This will increase pain, bleeding, herniation, and recovery time. Vaginal removal of a pelvic mass is commonly used by CIGC, and requires the use of a vaginal extraction device, or bag, that envelops the mass. Since the vagina is easily accessible from below, and the opening is naturally larger, removal of masses is easier with much less pain. The result is a fast, safe extraction with minimal recovery time.
Vaginal Port Applications
A vaginal port can be placed through the vagina, and instruments are used to manipulate and even dissect as required. This approach saves single and sometimes multiple abdominal wall incisions, decreasing pain and recovery times.
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