High Tech Help

April 01, 2012

Providence tackles gynecological conditions with advanced methods

Let’s face it, ladies: Reaching midlife brings a whole new set of health concerns and issues. And a new set of questions.

Whether you’re facing menopause, painful, heavy periods, uterine fibroids, ovarian cysts, endometriosis or—in the worst case— cancer, Providence offers answers and technologically advanced treatments to help you heal.

Smaller Surgeries, Bigger Benefits

Many gynecological conditions can be treated with a non-surgical approach or minimally invasive surgery. “The diagnostic process is really important. It takes some time and patience to move through the process, but finding the root cause of symptoms is essential,” says Steven A. Rabin, MD, a gynecologist affiliated with Providence Saint Joseph Medical Center.

The good news is, treatments are much less invasive than they used to be. Dr. Rabin describes several of the diagnostic and treatment procedures offered at all Providence medical centers in the San Fernando Valley and South Bay.

  • Hysteroscopy. This minimally invasive procedure, which does not require an incision, involves inserting a tiny telescope inside the uterus. “We have tools to remove fibroids with no external incision,” Dr. Rabin says. “Traditionally, women would have undergone a hysterectomy. This brings a major production down to an outpatient surgery.”
  • Hormonal treatments. “Heavy menstrual bleeding can often be addressed with hormones,” Dr. Rabin says. Sometimes a woman’s estrogen/progesterone levels simply get out of balance. In other instances— with endometriosis, for example—the temporary deprivation of estrogen in conjunction with laparoscopic surgery can alleviate pain.
  • Endometrial ablation. This minimally invasive procedure essentially cauterizes the lining of the uterus either by freezing it or burning it. Ablation can stop heavy bleeding associated with lining buildup.
  • Laparoscopy. Usually performed through two tiny incisions, laparoscopy can address ovarian cysts, ectopic pregnancy, early stage endometriosis and other benign conditions. “Some of the benefits of laparoscopy include faster recovery, less bleeding and scarring, better visualization of the affected area, better technology and instruments designed for accuracy through these small incisions,” Dr. Rabin says.
  • Vaginal or laparoscopically assisted hysterectomy. “Even though this is a major operation, it’s become a minor incision,” Dr. Rabin says, noting that hysterectomy is still a valid option for some women with pain, bleeding, endometriosis or uterine fibroids, based on what therapies worked or didn’t work.

What Robotic Technology Means for You

Providence Little Company of Mary Medical Center Torrance ushered in a new era of gynecological treatment in 2006 by launching a robotics program under the direction of Ramin Mirhashemi, MD. The da Vinci Si robotic system enables surgeons’ natural wrist, hand and finger movements to be translated into precise movements of micro-instruments.

“I have done a couple thousand robotic cases,” Dr. Mirhashemi says, noting that the da Vinci robot offers the same level of dexterity as you would find through an open incision. In stark contrast, however, to an open incision, the surgeon controls surgical instruments through four tiny incisions while a robotic camera “televises” the procedure on a 3-D, high-definition screen. “Because of the 3-D, high-acuity vision of the robotic camera, you’re able to have better accuracy. This leads to less pain, less scarring and faster recovery than with traditional, open surgery,” Dr. Mirhashemi says. “It’s an amazing technology.”

Robotic surgery at both Providence Little Company of Mary Torrance and Providence Saint Joseph can be a treatment option for uterine, cervical or ovarian cancers. “Prior to the robotics program, we were using large incisions to treat cancer. This caused prolonged recovery, more pain and additional potential post-op complications,” Dr. Mirhashemi says. “Now, because of the smaller incisions, recovery is faster. Cancer patients are ready to start treatment—either radiation or chemotherapy—often-times within two weeks.”

Robotic surgery also can be applied to advanced, benign gynecological conditions including large uterine fibroids, severe uterine prolapse (see page 14 for more) or stage 4 endometriosis. In some patients, robotic hysterectomy also is an option.