If surgical intervention is warranted, our specialists are experts in many minimally invasive procedures. We routinely treat complex cases, and are experienced in performing surgery on women who are obese, for whom surgery is risky.
For women who hope to have children
To treat menstrual problems in women who want babies, we can preserve the uterus using hysteroscopic, laparoscopic or abdominal techniques. Learn more:
Once we have examined the uterus with the hysteroscope, we can insert slender instruments through a separate channel to remove fibroids or other abnormal growths. These include endometrial polyps, finger-like growths arising from the uterine lining that can become infected and bleed. Tissue that remains after miscarriage can also trigger bleeding and may be removed hysteroscopically.
Minimally invasive myomectomy
Fibroid removal is known as myomectomy. Our gynecologists are highly skilled at removing difficult-to-access or large numbers of fibroids using minimally invasive methods. Fibroids may be removed hysteroscopically, through a scope inserted into the uterus; laparoscopically, through a scope inserted into the abdomen; or using a robotic laparoscope inserted into the abdomen (the robot streamlines suturing).
In addition, fibroids can be removed through a small incision in the belly, a less invasive form of open surgery called minilaparotomy.
When fibroids are too numerous or large, sometimes they must be removed in an open surgical procedure, through a bikini-line incision. The advantage is that the uterus can be repaired in layers, making it as strong as possible for subsequent pregnancies.
For women not interested in having children
Other options can end excessive bleeding without removing the uterus in older women or in younger women who do not want children but are not ready to enter menopause.
In this procedure, which can be done in the office or O.R., a thin layer of the uterine lining is destroyed using one of five equally effective devices. Heat, electrical current, laser energy or cold are applied to the inner walls of the uterus, halting periods.
Uterine fibroid embolization (UFE)
Cleveland Clinic gynecologists collaborate with Cleveland Clinic interventional radiologists on uterine fibroid embolization. This procedure is not for women who wish to conceive because its effects on the strength of the uterus are unknown. The radiologist guides a catheter to arteries that supply the fibroids, then inserts tiny plastic particles to block blood flow. This robs the fibroids of oxygen and nutrients, and the fibroids shrink over a period of months.