Minimally Invasive Gynecologic Surgery

UCLA Health excellence in minimally invasive gynecologic surgery

This surgical subspecialty uses smaller incisions and less invasive techniques to treat gynecologic conditions. UCLA Health minimally invasive gynecologic surgeons are dedicated to these innovative and safe surgical techniques to handle complex issues. Overall, this surgical approach can lead to shorter recoveries, less scarring and a lower risk of complications.

Highlights of our program include:

Patient-centered care: We educate you on all the possible surgical approaches and options. Then you and your doctor work together to find the treatment that’s best for you. This shared decision-making ensures that we account for your goals, needs and preferences when it comes to your surgical care.

Research-based treatments: Our surgeons conduct research studies devoted to improving women’s health. We continually bring you the latest effective treatment options. Eligible patients may have access to new treatments through clinical trials.

Personalized approach: While minimally invasive surgery can offer significant benefits for many patients, it’s not the right approach for everyone. Our surgeons offer minimally invasive options only if you are a candidate and the technique meets your unique needs. We tailor our surgical plans to each patient, using the approach that’s right for you.

Our specialties

Minimally invasive surgery is an umbrella term for surgical techniques that use small incisions, specialized surgical tools and high-tech cameras. These techniques contrast with an open approach, which uses one long incision to access the inside of the body. We specialize in several types of minimally invasive gynecology surgeries, including:

Hysteroscopic surgery

Hysteroscopic surgery involves no incisions at all. Instead, the surgeon places a camera (hysteroscope) through your cervix and into the uterus. This allows the surgeon to see and operate within the uterus. We often use hysteroscopic surgery to remove growths in the uterus (uterine fibroids or polyps). A hysteroscopy is usually an outpatient procedure, allowing you to return home the same day.

Laparoscopic surgery

In laparoscopic procedures, the surgeon makes one or more small incisions in the abdomen. They maneuver a camera and surgical instruments through the incisions so they can clearly see inside your body and perform the operation.

The exact number and size of the incisions can vary depending on your specific needs. Generally, you have three or four small incisions that are each between 0.5 and 1 centimeter long. Your surgeon may use laparoscopic surgery to treat endometriosis, ovarian cysts, uterine fibroids or to remove your uterus.

Robotic surgery

During robotic-assisted surgeries, the surgeon operates using computer-controlled robotic arms. They work from a computer console in the operating room, where they control the surgical robot throughout the entire procedure.

The surgeon makes a few small incisions in the abdomen, then uses the robot to direct a camera and surgical tools through the incisions. Using robotic arms allows for exceptional visualization and precision during surgery. An entire surgical team always supervises the robot while your surgeon performs the operation.

We may use a robotic approach to evaluate and treat endometriosis, ovarian cysts or pelvic organ prolapse. Surgeons may also use robotic techniques to remove your uterus, ovaries or fallopian tubes.

Vaginal surgery

In these procedures, the surgeon operates through the vagina without making any abdominal incisions. Vaginal surgery is the least invasive technique for a hysterectomy (uterus removal).

We may also use vaginal surgery to repair pelvic organ prolapse or treat urinary incontinence. Patients who have had at least one prior vaginal birth and have pelvic organ prolapse are the most common candidates for vaginal surgery.

Vaginal natural orifice transluminal endoscopic surgery (vNOTES)

vNOTES combines the benefits of laparoscopic and vaginal surgery. In this approach, the surgeon places the vNOTES device through the vagina and into the pelvic cavity. Then they can insert cameras and surgical tools through the device to operate with increased visualization and precision. This allows the surgeon to reach the uterus, fallopian tubes and ovaries without any need for abdominal incisions.

Our surgeons may use vNOTES to remove your uterus, ovaries, fallopian tubes or to treat uterine fibroids.

Conditions we treat

Conditions we treat with minimally invasive gynecologic surgery may include:

Abnormal uterine bleeding (AUB): Any uterine bleeding that is heavier than normal, or that occurs outside of expected times. AUB may include bleeding between periods, bleeding after sex, postmenopausal bleeding, prolonged menstrual bleeding, irregular menstrual cycles or not having a period at all (amenorrhea).

Adenomyosis: The tissue lining the inside of the uterus (endometrium) implants and grows within the muscular wall of the uterus

Endometrial or uterine polyps: Irregular growths of endometrial tissue that develop in the endometrium

Endometriosis: A condition in which the endometrium grows outside the uterus, often in the fallopian tubes, ovaries or tissue lining the pelvis

Fibroids: Small, noncancerous (benign) growths of connective tissue and muscle cells that develop in the uterus

Ovarian cysts: Small fluid-filled sacs that grow in or on the ovaries

Ovarian torsion: A twisted ovary

Pelvic organ prolapse: A condition in which one or more pelvic organs, such as the uterus, bowel or bladder, descend from their usual position and drop into the vagina

Urinary incontinence: A loss of bladder control, leading to accidental urine leaking

Treatments gynecologic surgeons offer

We offer a comprehensive range of surgical treatments, including:

Evaluation and removal of endometriosis: A gynecologic surgeon may use a laparoscopic or robotic approach for endometriosis diagnosis and treatment. With the help of a laparoscope and camera or a robotic arm, they can find the exact location of endometriosis and remove endometrial tissue that’s grown where it shouldn’t.

Hysterectomy: A hysterectomy is a procedure to remove the uterus. Patients may have a hysterectomy to treat AUB, fibroids or cancer. Hysterectomies are typically only a good option for patients who don’t want to become pregnant in the future or are past childbearing years. Vaginal surgery is the least invasive technique to perform a hysterectomy, although surgeons may also use laparoscopic, robotic or vNOTES approaches.

Myomectomy: This procedure removes uterine fibroids without removing the uterus itself. Our surgeons may use laparoscopic, vNOTES, hysteroscopic or robotic techniques to remove fibroids.

Oophorectomy: The surgeon removes one or both ovaries. The procedure may treat cancer, endometriosis, ovarian cysts or ovarian torsion. After ovary removal, patients can no longer produce eggs, but they may carry a pregnancy with the help of fertility treatments. Our surgeons use vNOTES, laparoscopic or robotic techniques to perform oophorectomies.

Ovarian cystectomy: Surgeons remove ovarian cysts, often using laparoscopic techniques. They insert a laparoscope and a camera through a few small abdominal incisions and use surgical tools to remove the cysts. We may also use robotic surgery or vNOTES to remove ovarian cysts.

Pelvic floor repair: We offer robotic surgery to reinforce the pelvic floor and bladder or treat pelvic organ prolapse. Our surgeons may also use vaginal surgery to repair vaginal prolapse, bladder prolapse or rectal prolapse.

Perineoplasty: This surgery repairs the perineum, the area between the thighs that protects the pelvic floor. Our surgeons use vaginal surgery to narrow the opening of the vagina and tighten the area between the vagina and anus. Patients may have a perineoplasty to restore function and improve sexual satisfaction after childbirth or a traumatic injury.

Salpingectomy: The surgeon removes part or all of one or both fallopian tubes. Patients may have a salpingectomy to treat cancer, reduce cancer risk, address a blocked fallopian tube or treat endometriosis in a fallopian tube. This procedure is typically reserved for patients who don’t want to become pregnant in the future or are past childbearing years. Our surgeons may use vNOTES, laparoscopic or robotic surgery.

Meet our team

Our minimally invasive gynecologic surgeons offer a broad range of procedures to help patients improve function and quality of life. We deliver exceptional care with an empathetic, warm approach. Our surgeons are leaders in clinical care and research, continually bringing our patients groundbreaking treatments.