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Reproductive Surgery

The Southeastern Center for Reproductive Surgery specializes in all aspects of gynecologic surgery related to fertility and infertility. Reproductive surgery is an art, and the most technically demanding of all gynecologic surgery. The Southeastern Center for Reproductive Surgery is proud of its reputation as the Southeast's premier center for reproductive surgery. Our experience and expertise allow us to perform approximately 90% of our operations laparoscopically on an outpatient basis.

The principle goal of reproductive surgery is to restore normal anatomy and function to the reproductive organs. Damage caused by inflammation, infection, or endometriosis leaves these structures more vulnerable to postoperative adhesion formation.

Therefore, standard surgical techniques are not appropriate for reproductive surgery, and these delicate procedures are best performed by a subspecialty trained and certified specialist in reproductive endocrinology and infertility.

Laparoscopic surgery is usually preferable to a standard open surgical approach, because this reduces handling of tissues, prevents drying of surfaces, and allows better access to and visualization of the deep pelvic structures. It also provides magnification and the ability to achieve more complete hemostasis. The net result is a better restoration of anatomy, decreased adhesion formation, lower risk of recurrence of endometriosis or pain, and higher pregnancy rates.

The following is a list of some important points to discuss with your reproductive surgery specialist prior to surgery:

Surgery for Endometriosis

  • Endometriotic implants may have varied appearances. All lesions should be treated.
  • Deep lesions should be completely excised or vaporized.
  • Endometriotic cysts in the ovary should be completely excised, never drained, ablated, or cauterized.
  • Adhesion barriers are sometimes used.
  • Post-op medical therapy may also be indicated.

Surgery for Adhesions

  • When possible, adhesions should be fully excised, not simply cut.
  • Complete hemostasis (stopping all bleeding and oozing) is crucial.
  • Adhesion barriers are often used.

Surgery for Tubal Damage or Occlusion

  • Magnification is usually needed to adequately repair the tube.
  • Sutures, if used, should be fine and placed sparingly.
  • Hemostasis is crucial

Surgery for Tubal Reversal

  • Operative magnification is critical.
  • Adhesions should be removed and cautery applied with micro forceps.
  • As much tubal length as possible should be salvaged.

Often, the first operation is a "make or break" procedure. If improperly performed, the damage caused may not be reversible. It is wise to ascertain your surgeon's experience and credentials well before you schedule surgery.

 

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