Hysterectomy (Open)- Hysterectomy (Laparoscopic)
- Myomectomy
- Reverseal of tubal ligation
- Tubal Ligation
- Breast Reconstrution
- Nipple and areola reconstruction
- Childbirth, C-Section
- Childbirth, Natural
- Myomectomy/Fibroidectomy
- Hysterectomy & Bladder Lift
Hysterectomy (Open)
The open hysterectomy is also called a total abdominal hysterectomy and is the "traditional" hysterectomy. It involves removal of the uterus and cervix (with or without removal of the ovaries or fallopian tubes) through a large abdominal incision, 4" to 6" long, which is made across the abdomen at the "bikini line." This is the most invasive type of hysterectomy, and also the most common. Total abdominal hysterectomy may be recommended if you have large fibroids that have not responded to hormone therapy or would be difficult to remove vaginally. It also may be the preferred procedure if you have severe endometriosis (uterine lining tissue that has found its way out of the uterus), pelvic infections, scarring from prior pelvic surgeries, or some types of cancer. Total abdominal hysterectomy is performed under general or regional anesthesia, and requires a hospital stay of 3-6 days and a long recovery period (up to 6 weeks or sometimes longer). Abdominal hysterectomy leaves a visible scar on your abdomen.
Hysterectomy (Laparoscopic)
A Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope called a laparoscope. This tiny instrument is inserted through a small cut in the abdominal wall and allows the surgeon to see into your abdomen. The major benefit of this kind of hysterectomy is that you will not need to have a large cut in your abdomen and your recovery is usually much faster. Your cervix, or the neck of the womb, is also removed during this operation. Your ovaries may or may not be removed depending on your wishes and your condition.
Myomectomy
Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved but are not guaranteed.
Before myomectomy, shrinking fibroids with gonadotropin-releasing hormone analogue (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, GnRH-a therapy can also improve anemia before surgery by stopping uterine bleeding for several months
Reverseal of tubal ligation
The the reversal procedure takes approximately one hour and overnight hospital stay is not needed. The tubal ligation reversal procedure uses microsurgery to rejoin the two remaining sections of the fallopian tubes. Certain factors have a direct effect on the potential for a successful tubal reversal procedure. Because the fallopian tube's diameter varies from one end to the other, the best chance for success occurs when the diameters of the two remaining sections of fallopian tube are almost identical. In cases where the two remaining ends of the tubes are of different diameter (for example, a narrow end of tube close to the uterus is being connected to a wider end near the end of the fallopian tube), success rates for pregnancy are lower.
Tubal Ligation
Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes. These tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant (sterile). The procedure takes about 30 minutes. Your surgeon will make one or two small surgical cuts in your belly, usually around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes. Your surgeon will insert a a narrow tube with a tiny camera on the end (laparoscope) into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate, very small cut. The tubes are either burned shut (cauterized) or clamped off with a small clip or ring (band). Tubal ligation can also be done right after you have a baby through a small cut in the navel or during a cesarean section.
Breast Reconstruction
Several types of operations can be done to reconstruct your breast. You can have a newly shaped breast with the use of a breast implant, your own tissue flap, or a combination of the two. (A tissue flap is a section of your own skin, fat, and muscle which is moved from your tummy, back, or other area of your body to the chest area.)
The most common implant is a saline-filled implant. It is a silicone shell filled with salt water (sterile saline). Silicone gel-filled implants are another option for breast reconstruction. They are not used as often as they were in the past because of concerns that silicone leakage might cause immune system diseases. But most of the recent studies show that silicone implants do not increase the risk of immune system problems. Also, alternative breast implants that have different shells and are filled with different materials are being studied, but you can only get them in clinical trials. One-stage immediate breast reconstruction may be done at the same time as mastectomy. After the general surgeon removes the breast tissue, a plastic surgeon places a breast implant where the breast tissue was removed to form the breast contour. Two-stage reconstruction or two-stage delayed reconstruction is done if your skin and chest wall tissues are tight and flat. An implanted tissue expander, which is like a balloon, is put under the skin and chest muscle. Through a tiny valve under the skin, the surgeon injects a salt-water solution at regular intervals to fill the expander over time (about 4 to 6 months). After the skin over the breast area has stretched enough, a second surgery is done to remove the expander and put in the permanent implant. Some expanders are left in place as the final implant. The two-stage reconstruction is sometimes called delayed-immediate reconstruction because it allows options. If the surgical biopsies show that radiation is needed, the next steps may be delayed until after radiation treatment is complete. If radiation is not needed, the surgeon can start right away with the tissue expander and second surgery.
Nipple and areola reconstruction
You can decide if you want to have your nipple and the dark area around the nipple (areola) reconstructed. Nipple and areola reconstructions are optional and usually the final phase of breast reconstruction. This is a separate surgery that is done to make the reconstructed breast look more like the original breast. It can be done as an outpatient after drugs are used to make the area numb (under local anesthesia). It is usually done after the new breast has had time to heal (about 3 to 4 months after surgery). The ideal nipple and areola reconstruction requires that the position, size, shape, texture, color, and projection of the new nipple match the natural one. Tissue used to rebuild the nipple and areola also is taken from your body, such as from the newly created breast, opposite nipple, ear, eyelid, groin, upper inner thigh, or buttocks. A tattoo may be used to match the color of the nipple of the other breast and to create the areola.
Our Gyn-Ob Surgeons
Costamed / Cozumel, Mexico
Dr. David Olivares
Amerimed Hospital / Cancun, Mexico
Dra. Minerva Salgado
Hospital la Catolica / San Jose, Costa Rica
Dra. Nadia Srur Rivero
Dr. Alejandro Villalobos
Clinica Unibe / San Jose, Costa Rica
Dr. Leonardo Jimenez Fernandez
Galenia Hospital / Cancun, Mexico
Dra. Hernandez Ojeda Perla Marilu
