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Fibroids? Hysterectomy?

April 30, 2019

Same-day surgical procedure with faster recovery is now possible 

Last fall, veterinarian Priti Goswami, DVM, PhD, found herself in Overlook Medical Center's Emergency Department for the second time in 48 hours. Her first visit to the ED, for a high fever, resulted in a prescription for an antibiotic that doctors thought would bring her back to health. But something more complex was brewing, and when that antibiotic did not show any sign of working and Priti developed uncontrollable chills as her fever continued to rise, she returned to Overlook via ambulance and was admitted to the hospital.

Over the course of a few days, Priti was seen by several physicians, all working together to pinpoint the cause of her fever and the appropriate treatment. Meher Sultana, MD, a specialist in infectious diseases, determined that Priti was most likely suffering from an unusual infection in her uterus. It was then that Janine Doneza, MD, a gynecologic surgeon fellowship-trained in robotic and minimally invasive surgery, was asked to weigh in on Priti’s case. In addition to the infection, Priti – like so many women – had put up with years of pelvic pain and severe vaginal bleeding due to uterine fibroids. Once she finished another course of antibiotics and put the infection behind her, she and Dr. Doneza discussed the options for treating those fibroids. 

A Better Solution to Common Problems

What made Priti’s situation unique, explains Dr. Doneza, was the size of one such fibroid. An MRI revealed a fibroid nearly 8 centimeters in diameter; her uterus was enlarged to 16 centimeters as a result. Those factors – combined with adhesions and scarring from two cesarean sections, a prior dilation and curettage, and the aftermath of the aforementioned infection – led doctor and patient to the decision that a hysterectomy was Priti’s best option for relief. In years past, the only option for hysterectomy involved a large, open surgery through the abdomen. But now, explains Dr. Doneza, women who require a hysterectomy or other major procedures for gynecologic conditions that can cause pain or disruption may have another option: minimally invasive gynecologic surgery (MIGS).

The Benefits of MIGS

These state-of-the-art procedures use small incisions, resulting in less pain, blood loss and scarring; a decreased risk of infection; shorter hospital stays, and a faster return to daily activities. Many MIGS can even be performed on an outpatient basis. Conditions treated by minimally invasive gynecologic surgery include abnormal uterine bleeding, adenomyosis, endometrial polyps and endometriosis, ovarian and paratubal cysts, pelvic pain, and uterine fibroids.

“Times are changing and there are more subspecialties in the field of surgery as it pertains to women’s health,” says Dr. Doneza. “Minimally invasive gynecologic surgery is one part of that. Most of the hospitals that have made this distinction are large academic centers. I’m excited that Overlook has established minimally invasive surgery as a division of the department of obstetrics and gynecology. All women deserve this level of care.”

Atlantic Health System’s MIGS surgeons are board-certified, fellowship-trained gynecologists with experience in the use of hysteroscopic, laparoscopic and robotic-assisted techniques. Dr. Doneza points out that surgeons with this advanced level of training are able to take on more complex cases and still use a minimally invasive approach. “If you can minimize doing a larger surgery with the same outcomes, that’s better for the patient,” she says.

Just a few weeks after surgery, Priti was enjoying all the things she loves – her work, time with her children, travel and more – without the pelvic pain and bleeding that shadowed her for years. “I should have had surgery at least a year prior,” she says. “It wasn’t worth trying to escape it. Dr. Doneza was very professional and compassionate. She explained everything so well, and my experience was so much easier because of her. The way she took control of things was so reassuring. Now I’m back to business!”

Learn more about MIGS >