News & Views - General Announcements
Robert Neuwirth, MD, chairman of the Department of Obstetrics and Gynecology from 1974-1991, passed away on Tuesday, December 17. Dr. Neuwirth had a long and active professional life, making many vital contributions to our field. He was a pioneer of minimally-invasive techniques that avoid large incisions during gynecologic surgery.
Dr. Neuwirth obtained his medical degree from Yale University in 1958, and completed his obstetrics and gynecology residency at Columbia-Presbyterian Medical Center in 1962. In 1974, he became chairman of the Department of Obstetrics and Gynecology at St. Luke’s Hospital Center, on the Upper West Side of Manhattan. When West Hospital and St. Luke’s Hospital Center merged in 1979, he continued as chairman of the joint Obstetrics and Gynecology Department until 1991. In addition, from 1977-2000, he was the F. Huntington and Dorothy B. Babcock Professor of Obstetrics and Gynecology at the Columbia University College of Physicians and Surgeons. He also served as an examiner for the American Board of Obstetrics and Gynecology from 1982-1998.
Dr. Neuwirth introduced gynecologic laparoscopy in the United States in 1968, with research articles on laparoscopic sterilization and ovarian biopsies. In 1969, Dr. Neuwirth introduced hysteroscopy—the use of a telescope to look into the uterus—and authored a monograph on the technique in 1974. In 1976, he developed resectoscopic surgery of submucous fibroids.
A key contribution of Dr. Neuwirth’s was his ongoing research into minimally-invasive treatments for abnormal uterine bleeding, all allowing women to avoid hysterectomy. In 1992, Dr. Neuwirth authored the first report on long-term outcome of menstrual function following hysteroscopic endometrial ablation. Dr. Neuwirth is also the inventor of balloon endometrial ablation, widely used today, and typically carried out in a doctor’s office. Just recently, Dr. Neuwirth published an article detailing his basic research into the use of silver nitrate as a chemical means to control abnormal bleeding; he held the patent on the procedure and hoped that, one day, it would provide a simple and inexpensive means for women in developing countries to avoid hysterectomy.
The Least-Invasive Route for Gynecologic Surgery is Through the Vagina
Lisa Dabney, MD
There has been a lot of talk in the media about minimally-invasive surgery for uterine fibroids, endometriosis, and other noncancerous gynecologic problems. The route discussed for these surgeries is usually laparoscopic; that is, through small incisions in the abdomen for insertion of a camera and instruments. While this approach has revolutionized some procedures, especially those for cancer cases, sometimes the practice of laparoscopy overshadows the least invasive approach for noncancerous gynecological conditions: the vaginal approach.
An incision made though the vagina heals almost without a scar and causes minimal postoperative pain for the patient. Such an incision allows access to, and removal or repair of, affected pelvic organs and their support structures. This is logical: the vagina is right next to the areas of concern. There is no need to cut through abdominal muscles, push away bowels, and distend the abdomen with air. Cysts and fibroids can also be removed through the vaginal, as well.
Women are given a variety of reasons why they cannot have vaginal surgery: because they have had prior pelvic surgery, such as cesarean section or myomectomy; because they haven’t had any vaginal deliveries; or, because their fibroids are too large.
None of these are reasons to exclude the vaginal approach, if the surgeon is experienced with it. In fact, for most patients, the surgical route of choice should always be through the vagina. Adding the laparoscope only increases the time in surgery, amount of anesthesia, and amount of postoperative pain and length of recovery time for the patient.
The American College of Obstetricians and Gynecologists states that vaginal surgery is the route of choice when performing hysterectomy for noncancerous indications. Fortunately, there are many alternatives to hysterectomy and to other types of gynecologic surgery these days. But if you find you need gynecologic surgery, the vaginal approach is almost always the best approach.
Ob/Gyn Faculty Present Research at National and International Conferences
Department members regularly present their clinical research projects at the annual meetings of a number of professional and medical societies. Please follow the link to view a sampling of recent research posters from these events.