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Minimally-Invasive Surgery and Robotics

Physician leaders from several areas of the Department of Obstetrics and Gynecology have come together to offer a wide range of minimally-invasive surgical treatments for gynecologic problems. These new treatments are as safe and effective as their traditional counterparts requiring a major incision, and come with a host of advantages: less scarring, shorter hospital stay and recovery time, and fewer potential complications.

Below are descriptions of the various procedures we offer. Under each description, you will find the names of the physicians who provide the procedure, with links to their biographical information and other specialities they may participate in or direct.

Minimally-Invasive Treatments for General Gynecologic Problems

We offer minimally-invasive treatment for many non-cancerous gynecologic conditions. For example, many women suffer from fibroids. Fibroids are benign tumors within the uterus, and are also called myomata. They can cause heavy menstrual bleeding, pelvic pain and pressure, and miscarriages.

Surgery by the Vaginal Route

Vaginal surgery is the least invasive approach for many procedures because the patient ends up with no incisions on her abdomen. The only incision is made through the vagina. In addition to this, the surgeries are often shorter and require less anesthesia than the abdominal route. Patients also recover more quickly. Our specialists do many hysterectomies through the vagina that other New York City surgeons would only perform abdominally. Vaginal hysterectomy has been found to be the route of choice by recent scholarly publications. Vaginal ovarian cystectomy and vaginal myomectomy, specialties of Dr. Dabney, respectively allow ovarian cysts and fibroids to be safely removed through the vagina.

Physicians:

Lisa Dabney, MD, FACOG
Deepti Gupta, MD, FACOG
Anne Hardart, MD, FACOG
Renuka Paka, MD, FACOG


Laparoscopic Hysterectomy and Myomectomy

These procedures are much less invasive than conventional, "open" abdominal surgeries, and utilize a camera and instruments inserted through minor incisions to remove the uterus or fibroids.

Physicians:

Deepti Gupta, MD, FACOG
Anne Hardart, MD, FACOG

Konstantin Zakashansky, MD

Laparoscopic Surgery for Endometriosis

In endometriosis, the tissue lining the uterine cavity (the endometrium) implants outside the uterus, often on the ovaries, fallopian tubes, bowel or other pelvic or abdominal locations. Similar to the uterine endometrium, endometriosis implants can bleed during menses, causing pain, inflammation and scarring. Endometriosis can be a severe problem that requires complex surgical treatment. With laparoscopy, a camera allows surgeons to look inside the belly and safely remove the endometriosis implants without a major incision. Our surgeons also have use of the Da Vinci Robot, increasing dexterity and making even the most difficult endometriosis surgeries possible laparoscopically.

Physicians who perform laparoscopic surgery for endometriosis:

Anne Hardart, MD, FACOG
Deepti Gupta, MD, FACOG
Daniel Stein, MD, FACOG

Konstantin Zakashansky, MD

Laparoscopic Treatment of Simple Ovarian Cysts

Ovarian cysts are very common in women throughout their reproductive lives. For ovarian cysts that have been identified as simple on ultrasound examination, the risk of cancer is reduced. In these cases, laparoscopic treatment can be performed by several of our experienced gynecologists. (For complex ovarian cysts, please see the next section.)

Physicians:

Lisa Dabney, MD, FACOG
Deepti Gupta, MD, FACOG
Anne Hardart, MD, FACOG
Renuka Paka, MD, FACOG
Konstantin Zakashansky, MD


Minimally-Invasive Surgery for Women’s Cancers

In the Division of Gynecologic Oncology, minimally-invasive surgical staging and treatment for ovarian, cervical and endometrial cancer are continually being advanced. These are used in concert with state-of-the-art chemotherapy and radiation treatment to provide complete and effective care. In this way, women are avoiding conventional, open surgery even for many of the most serious cancers, thus achieving easier recovery and better quality of life along with comparable treatment success.

Laparoscopic Treatment of Complex Ovarian Cysts

In the Division of Gynecologic Oncology, we offer laparoscopic evaluation and removal of complex ovarian cysts. During surgery, a small percentage of complex ovarian cysts are discovered to be early ovarian cancer. Having your ovarian cyst removed laparoscopically by a gynecologic oncologist will allow you to avoid a major incision while still ensuring that if cancer is found, you will receive effective care.

Physicians:

Konstantin Zakashansky, MD

Minimally-Invasive Surgery for Early Ovarian Cancer

Farr R. Nezhat, MD, FACS, was lead author on a recent  comprehensive study of minimally-invasive surgical treatment for early cancers of the ovary and fallopian tube. The study was published in the January issue of the American Journal of Obstetrics and Gynecology. The study is one of the largest and longest in duration of follow-up time to date. It strengthens the evidence that minimally-invasive staging of these cancers does not compromise survival when performed by gynecologic oncologists experienced in advanced laparoscopy.

Physicians:

Konstantin Zakashansky, MD

Physicians who treat ovarian cysts and early ovarian cancer laparoscopically:

Konstantin Zakashansky, MD

Certain Advanced or Recurrent Ovarian Cancers

Laparoscopy has been shown very effective for evaluation and treatment of patients with certain advanced or recurrent ovarian cancers. A combination of radical surgery and chemotherapy is indicated, and very few physicians have the extensive experience of Farr Nezhat, MD, who has pioneered the treatment of these patients.

Physician:

Konstantin Zakashansky, MD

Laparoscopic, Robotic Hysterectomy for Endometrial Cancer

For endometrial cancer, we offer a very advanced treatment, laparoscopic, robotic hysterectomy and lymphadenectomy. In this procedure, the Da Vinci Robot is used to augment the laparoscopic removal of the uterus and lymph nodes. The robot enables our surgeons to do more complex operations laparoscopically than would otherwise be possible.

Physicians:

Konstantin Zakashansky, MD

Fertility-Conserving Treatment for Early Cervical Cancer

Certain patients with early cervical cancer are candidates for radical cervical trachelectomy, a minimally-invasive removal of the cervix, in which the uterus and ovaries are retained for childbearing. Studies have shown that cervical trachelectomy has a similar cancer-treatment outcome to radical hysterectomy. Patients studied were able to conceive at a rate similar to the general population, with only a slightly increased risk of pregnancy loss. Dr. Nezhat was one of the first surgeons to employ the Da Vinci Robot in this laparoscopic procedure, and is one of few surgeons who are very experienced in its performance.

Physician:

Konstantin Zakashansky, MD

Minimally-Invasive Radical Hysterectomy and Lymphadenectomy for Cervical Cancer

For cervical cancer, we offer a very advanced, minimally-invasive treatment, robotically-assisted laparoscopic radical hysterectomy and lymphadenectomy. The robot enables our surgeons to do more complex operations without a major incision than would otherwise be possible. In this procedure, the Da Vinci Robot is used to augment the laparoscopic removal of the lymph nodes, uterus, parametrium, and cervix.

Physicians:

Konstantin Zakashansky, MD

More About the Division of Gynecologic Oncology


Minimally-Invasive Surgery for Bladder Control and Pelvic Organ Support

Pelvic floor disorders include bladder control problems (urinary incontinence), fecal incontinence, and pelvic organ prolapse—that is, the dropping or falling of the uterus, bladder, rectum, and vagina. Many women find relief from prolapse or stress incontinence without surgery. However, pelvic reconstructive surgery is the only way to permanently correct these problems.

In the Division of Urogynecology, a typical surgical treatment is performed through the vagina and without a major incision. The division’s physicians are accomplished and flexible surgeons who will modify their procedures to best correct your problem. At your request, they will employ surgical techniques that conserve the uterus.

Physicians:

Anne Hardart, MD, FACOG
Lisa Dabney, MD, FACOG

More About the Division of Urogynecology and Reconstructive Surgery


Minimally-Invasive Fertility Surgery

Diagnostic and Operative Hysteroscopy and Laparoscopy. Fertility problems may be diagnosed and corrected by these procedures, which avoid large incisions by the use of cameras to visualize the abdomen or the interior of the uterus.

Physicians:

Daniel Stein, MD, FACOG

More about RMA Westside

OB Gyn Gynecology St. Luke's Hospital New York Manhattan Pregnancy Risks Specialist Midwife Physicians Home
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OB Gyn Gynecology St. Luke's Hospital New York Manhattan Pregnancy Risks Specialist Midwife Physicians Minimally-Invasive Treatments for General Gynecologic Problems
OB Gyn Gynecology St. Luke's Hospital New York Manhattan Pregnancy Risks Specialist Midwife Physicians Minimally-Invasive Surgery for Women’s Cancers
OB Gyn Gynecology St. Luke's Hospital New York Manhattan Pregnancy Risks Specialist Midwife Physicians Minimally-Invasive Surgery for Bladder Control and Pelvic Organ Support
OB Gyn Gynecology St. Luke's Hospital New York Manhattan Pregnancy Risks Specialist Midwife Physicians Minimally-Invasive Fertility Surgery