Burnsville: (952) 435-4190 | Edina: (952) 920-2200


Surgery

Surgery

Please check the information on this page for details about some of the surgeries we perform.  As always, we are here to answer any additional questions you may have regarding these procedures.

  1. 1
    Endometrial Ablation

    Information about your first exam

    This information is intended to be used as a guideline for our patients who are undergoing endometrial ablation. There are several companies that manufacture products that can be used to accomplish an endometrial ablation. Your doctor has chosen a method that is appropriate for your particular circumstance.

    The ablation procedure is meant to destroy the lining of the uterus (endometrium) so your periods will be lighter, or in some cases, non-existent. Ideally, the procedure is performed on days 6-10 of your cycle, with day 1 being the first day of menstruation.

    Endometrial ablation is performed as an outpatient procedure at the hospital or Women’s Procedure Suites. The procedure is performed under general anesthesia (going to sleep) or sedation and is scheduled for 15-30 minutes. The procedure is sometimes scheduled as:  D&C, Hysteroscopy with Endometrial Ablation. This allows for your doctor to have any necessary equipment available at the time of your procedure.

    After surgery, you may experience a wide variety of symptoms. Light to moderate bleeding, menstrual type cramping and pink or yellow watery discharge, are all considered normal. These symptoms can last for several days to several weeks following the ablation procedure. These symptoms are due to the sloughing and healing of the lining of the uterus. It is not unusual for these symptoms to start and stop or change from heavy to light several times during the healing process. You should plan to wear a light pad or panty liner for at least one month following your procedure.

    In some cases, your first few periods may continue to be heavy and then improve. Generally, Acetaminophen or Ibuprofen will be adequate for postoperative pain control.

    If you experience abdominal pain, fever (over 100.4o), heavy bleeding or greenish vaginal discharge you should call the office.

    • You may return to work and most activities a day or two following your procedure.
    • You should refrain from tampon use for 2 weeks following surgery. 
    • You should refrain from intercourse for 2 weeks following surgery. 

    Please make an appointment to follow up with your doctor 4-6 weeks after surgery.

  2. 2
    Hysterectomy Patient Guidelines

    It is our goal for you to have the best possible outcome from your hysterectomy. The key to a successful recovery is information and communication. We encourage you to use this as a guide in your recovery.

    Prior to Surgery:

    In addition to this information, you will receive one or two phone calls from the hospital. The hospital will go over pre-registration information and a nurse will discuss additional pre-operative instructions. If you are having surgery at Fairview Ridges Hospital, they may ask you to come in the day before your surgery for a blood type and screening. If you have any further questions or concerns regarding your upcoming surgery please call and speak with surgery scheduling or your physician.

    Day of Surgery:

    You will be asked to arrive at the hospital 1½-2 hours prior to your surgery time. This allows time to complete the admission process. A nurse will check your blood pressure, pulse and temperature and have you sign your surgery consent form. You will be taken to a pre-op holding area where your I.V. will be started and a representative from the anesthesia department will come and speak with you. This will be either a nurse anesthetist or an anesthesiologist (MD). Your medications, allergies and medical history, including any previous anesthesia experiences, will be discussed with you. Jointly, in cooperation with your surgeon, the anesthesia department will determine the best anesthetic technique for your circumstance. The options are either general anesthesia (going to sleep) or regional anesthesia (a spinal or epidural block which involves giving you a sedative and then an injection in your back, resulting in numbness from the area of the waist to toes). Postoperative pain management will also be discussed at this time. Surgery can last from 1-2½ hours.

    Following Surgery:

    Immediately following surgery you will be taken to the recovery room. Your vital signs will be monitored often and you will be given oxygen. As soon as you are deemed stable to be transported, you will be taken to your room. Once in your room, IV fluids will be continued until you can resume drinking fluids on your own. Your nurse will inform you when you can have solid foods. The nurse will assess your pain by asking you to rate it on a scale of 0-10. (0 being no pain and 10 being the most intense pain) You will be offered pain medication as ordered by your doctor. You will be encouraged to turn, cough and deep breathe. You will be asked to flex your feet and ankles to improve blood flow. You will also be assisted out of bed and encouraged to walk in your room or the hallways to facilitate your recovery. The staff will assess your urine output, fluid intake, pain management and activity tolerance. They will check your incision/dressings. If vaginal packing is used, the packing will be removed the day after surgery. As soon as you are able, you will be changed to oral pain medications.

  3. 3
    Laparoscopic Supracervical Hysterectomy (LSH)

    LSH is performed by inserting a laparoscope and additional surgical instruments through one to four small abdominal incisions. The incisions are one inch or smaller. If one incision is used, it is within the folds of the umbilicus. If additional incisions are needed they are at the bikini line and also on the right or left side of the abdomen.

    The uterus can be removed through these small incisions by morcellation (breaking it up into small pieces). Advanced technology for hemostasis (controlling blood loss) also makes it possible for hysterectomy to be completed through the laparoscope. This technique allows the physician to remove the uterus but leave the cervix in place (also known as subtotal or partial hysterectomy). The ovaries can also be removed with this method if needed.

    LSH surgery is scheduled as an outpatient surgical procedure. You are asked to arrive at the hospital 1½ to 2 hours before surgery. The anesthesia team will speak with you about the anesthesia and any special needs. An IV with an antibiotic (to help prevent infection) will be started. You will have general anesthesia (going to sleep). A catheter will be placed in your bladder, to drain urine, after you are asleep.

    Surgery is scheduled for 1 to 2 hours. After surgery, you will go to the recovery room. You will leave the hospital approximately 3-5 hours after the surgery is completed. Occasionally, you may also be kept overnight for observation. The decision about when you will be released from the hospital can only be made after surgery is performed. Pain management and anesthesia recovery will be assessed and will determine when you are discharged.

    Carbon dioxide is used to inflate the abdomen for your surgery. Most of this gas is removed at the end of the procedure. Some of the gas can get trapped in your abdomen and may cause you to feel bloated, have abdominal cramping or have pain in your shoulder area. This discomfort usually lasts only a day or two.

  4. 4
    Total Laparoscopic Hysterectomy (TLH)

    TLH is performed by inserting a laparoscope and additional surgical instruments through one to four small abdominal incisions. The incisions are an inch or smaller. If one incision is used, it is within the folds of the umbilicus. If additional incisions are needed they are at the bikini line and also on the right or left side of the abdomen.

    The uterus can be removed through these small incisions by morcellation (breaking it up into small pieces). Advanced technology for hemostasis (controlling blood loss) also makes it possible for hysterectomy to be completed through the laparoscope. This technique allows the physician to remove the entire uterus including the cervix. The opening to the vagina is closed with absorbable stitches. The ovaries can also be removed with this method if needed.

    TLH surgery is scheduled as an outpatient surgical procedure. Patients are asked to arrive at the hospital 1½  to 2 hours before surgery. The anesthesia team will speak with you about the anesthesia and any special needs. An IV with an antibiotic (to help prevent infection) will be started. You will have general anesthesia (going to sleep). A catheter will be placed in your bladder, to drain urine, after you are asleep. Surgery is scheduled for 1 to 2 hours. After surgery, you will go to the recovery room. You will leave the hospital approximately 3-5 hours after the surgery is completed. Occasionally, you may be kept overnight for observation. The decision about when you will be released from the hospital can only be made after surgery is performed. Pain management and anesthesia recovery will be assessed and will determine when you are discharged.

    Carbon dioxide is used to inflate the abdomen for your surgery. Most of this gas is removed at the end of the procedure. Some of the gas can get trapped in your abdomen and may cause you to feel bloated, have abdominal cramping or have pain in your shoulder area. This discomfort usually lasts only a day or two.

    Some vaginal bleeding/spotting can be expected after surgery. If the bleeding becomes heavy, call the clinic right away.

    When to call:

    - Bright red and/or heavy bleeding
    - Severe chills or fever of greater than 100.4o
    - Incision is hot, red or tender
    - Urinary burning or frequency
    - More than 3 days without bowel movement 

    • You may increase most activity as tolerated.
    • You may shower at any time.
    • Avoid soaking in the tub, spas or pools for 1 week.
    • Driving can be resumed as soon as you have a normal energy level and are no longer taking narcotic pain medication. (oftentimes, over the counter pain relievers are all that is needed for pain control)
    • Lifting, pushing, pulling or carrying (more than 15 pounds) should be avoided for six weeks after surgery.
    • Return to fitness activities six weeks after surgery. 
    • Intercourse may be resumed six weeks after surgery.
    • Stitches to close the incision(s) are under the skin and will dissolve on their own. Incisions may be gently washed over and covered with a band-aid if needed. No additional ointments or creams should be used.

    The TLH patient can usually return to work that is not too physically demanding two weeks after surgery. If your job requires more strenuous activity, ask your doctor when it is safe to return.

    A follow up appointment should be made for approximately two weeks after surgery. Some doctors want to see you at two weeks and six weeks after surgery.

  5. 5
    Pubovaginal Sling

    What is a pubovaginal sling?

    This procedure is performed for certain types of urinary incontinence. Urine leakage occurs be because the bladder has lost some of its support. This procedure may prevent or greatly reduce urine leakage.

    The sling is made of mesh. Your doctor will place the sling under the urethra (the tube that leads from the bladder to outside your body). This restores the urethra to a more natural/normal position.

    Procedure Day

    You will be asked to arrive at the hospital 1½ hours prior to your procedure. The hospital staff will prepare you for surgery. You will have an antibiotic (for infection prevention) as part of your I.V. The anesthesia staff will give you a general anesthesia (going to sleep). Once you are asleep, a catheter (small tube) will be placed in your bladder. The catheter can drain urine and also act as a guide for your doctor. Your doctor will make a total of 3 small incisions. The doctor will pass the sling though the incisions to place it in position and adjust the tension. The incisions are closed with sutures that dissolve on their own. The catheter will be removed from your bladder. You will wake up in the recovery room. You will be asked to empty your bladder when you are ready. For most women the bladder will empty well. Some women may have difficulty emptying their bladder after surgery due to swelling.

    In the event you have problems emptying your bladder, we will put another catheter in your bladder to drain the urine. You may go home with a catheter and a bag to drain your urine. The swelling should go away after 2-7 days and you will be asked to return to the office to have your catheter removed. An antibiotic may be prescribed to help prevent infection while the catheter is in place.

    After going home

    You may have some discomfort. Urination may feel different. You may feel the need to empty “right away”. This should improve with time. You may notice light vaginal spotting for up to 4 weeks. The spotting may occur on and off. If the spotting is more than a small amount, call our office.

    Restrictions for 6 weeks after surgery

    • Avoid long walks (over one mile) and any type of vigorous exercise.
    • Do not lift anything that weighs more than a gallon of milk.
    • Avoid heavy activity such as golf, vacuuming, snow shoveling, biking or swimming.
    • Avoid lifting heavy objects such as laundry baskets and grocery bags.
    • Do not soak in the bathtub for 1 week.  Shower instead.

    Other guidelines

    • You may have some mild pain after surgery.
    • You may use a heating pad.
    • You may take over the counter Tylenol, Extra strength Tylenol, Ibuprofen, Motrin, Advil or Aleve as needed and as directed on the bottle.
    • Take narcotics only if you cannot control your pain with the above.
    • Never take narcotics with alcohol.  Narcotics can cause confusion, nausea, constipation and other side effects.
    • Most women can drive after two days.  Do not drive however, until you feel 100% able to respond to an emergency on the road.  Never drive while taking narcotic pain medication.
    • No tampon use for two weeks after surgery.
    • No intercourse for four weeks after surgery.
    • If you have a desk job, you may return to work in 3-5 days.
    • If your job involves more activity, ask your doctor when it is safe to return.

    What are the risks?

    • Like any surgery, this treatment has some risks as well.
    • Bleeding
    • Infection
    • Damage to organs (bowel or bladder)
    • Reaction to anesthesia
    • Problems emptying your bladder after surgery
    • Leakage in the future

    Please contact us right away if you have:

    • Fever of over 100.4o
    • Heavy bleeding from incisions or vagina
    • Redness or warmth around incisions