We are subspecialists in the field of urogynaecology and minimally invasive (camera/ keyhole) surgery. We cover a wide range of gynaecologic conditions including vaginal prolapse, incontinence and laparoscopic approach to benign gynecological conditions. We have specialized training in laparoscopic management of large fibroids (laparoscopic myomectomies and hysterectomies) as well as endometriosis and ovarian cysts.
Vaginal Laser treatment
Vaginal Laser treatment is a new non-surgical option for vaginal relaxation syndrome, mild vaginal prolapse, mild vaginal incontinence and vaginal atrophy/dryness. The treatment does not require any general anaesthesia and is done in the office.
Loss of urine can be a life-altering problem. With a proper evaluation of patient history, physical exam, and testing, we are able to determine the cause of the patient’s incontinence and treat her appropriately. Some of the surgical techniques we offer are midurethral slings: TVT’s and TOT’s, Laparoscopic Burch procedure and fascial slings.
The process involves the filling of your bladder with saline and monitoring the activity of your bladder and leaking episodes under different pressure conditions. The whole procedure takes just over 30 minutes and is well tolerated without any anesthetic. If we are unsure about the diagnosis, if you had previous incontinence surgery or if we are planning surgery we may use this as a diagnostic tool.
This procedure involves the visualization of the inside of the bladder with a special camera. It is mostly used as a diagnostic aid.
This treatment is reserved for patients with a resistant overactive bladder who has failed first line therapy. It involves injecting the bladder with a small dose of Botox through a cystoscope to relieve the symptoms of an overactive bladder. Repeat injections are usually necessary every 3-12 months.
This treatment is reserved for patients with a resistant overactive bladder who has failed first line therapy. It involves the placement of a permanent bladder pacemaker in the buttock region to communicate with the bladder with the aim of resolving/decreasing the symptoms related to overactive bladder.
Pelvic reconstruction surgery for PROLAPSE
The vagina and uterus are supported with fibro-muscular tissue which can stretch and relax resulting in vaginal pressure; protrusion of the uterus, bladder, or rectum; and/or marked relaxation of the vaginal opening. We are able to reconstruct these tissues in a minimally invasive nature by using evidence based surgical techniques (e.g. laparoscopic colposacropexy) giving the patient excellent support and very satisfying results.
Total Laparoscopic Hysterectomy
Hysterectomy means the removal of the uterus, which is usually accompanied by the removal of the cervix as well. There are numerous indications for performing hysterectomies. This may include uterine fibroids, abnormal uterine bleeding, endometriosis, pelvic pain and premalignant lesions of the uterus to name a few.
Hysterectomies are typically done through a larger abdominal incision, through small incisions with the assistance of laparoscopy, or vaginally. The method used is determined by the patient’s physical findings.
We do the majority of our hysterectomies with the assistance of the laparoscope. With this technique, the patient is usually discharged the morning after surgery and can be back to routine, non-strenuous activity within a week.
Heavy period treatment
There are numerous reasons for heavy menses. Once a proper examination is performed along with appropriate testing, we will tailor the treatment accordingly. The patient’s history, physical exam, age, medical history, weight, and test results are carefully considered before any treatment is advised.
The hysteroscopy is a very useful tool used to determine the size, contour, and structural abnormalities of the uterine cavity (inside of the uterus). We use a very small, flexible scope which allows us to perform the procedure in the office with very little, if any, discomfort. Since the device is attached to a camera and video screen, the patient is able to witness our exact findings.
This condition often presents with chronic pelvic pain, painful periods, painful intercourse or infertility. Treatment options include medication or surgical intervention. We utilize key hole surgery if surgery is indicated.
Laparoscopic cerclage for recurrent miscarriage
woman who are unable to carry a pregnancy to term gestation due to cervical incompetency and has failed a vaginal cerclage are suitable for this procedure. The laparoscopic abdominal cerclage can be done prior to pregnancy or in early pregnancy in the first trimester.
There are occasions when a patient has had a tubal ligation and then decides to have another child. To determine if a patient is a proper candidate for tubal reanastomosis (re-connecting), we must consider her age, the amount of tube removed, and her physical findings. If she is a candidate, we are able to successfully reconnect her tubes laparoscopically on a day surgery basis.
Issues related to menopause are complex and require a lot of time, consideration and planning. Since the historical data regarding the safety and efficacy of hormonal therapy is in constant flux, we keep abreast with the up-to-date data and always consider the benefits, risks, and quality of life issues when counseling our patients.
The advantage of a laparoscopic myomectomy over an abdominal myomectomy is that several small incisions are used rather than one larger incision.Not all surgeons are trained in laparoscopic surgery; because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically. Many subserous fibroids (close to the outer surface) can also be removed through the laparoscope.