In-Office Procedures

Services: In-Office Surgical

In-Office Surgical Procedures

Our board-certified physicians perform several In-Office Surgical and Medical Procedures, making it a safe and positive experience for our patients.

Our board-certified physicians and nurse practitioners are committed to serving you, the whole woman, through every age and stage.  Their wide range of specialized training and expertise provides patients with the best medical care possible.

Our team has a combined 50 years of experience and a shared goal of providing every patient who walks through our doors the best possible care.

 

Our team uses minimally invasive surgical techniques to provide a quicker and less painful recovery.

Yasmines Alifonso Amador, MD, FACOG

In-Office Procedures

Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope. It shines a light into the vagina and onto the cervix. A colposcope can significantly enlarge the standard view. This exam allows an obstetrician-gynecologist (ob-gyn) to find problems that cannot be seen by the eye alone.

Why is colposcopy done?

Colposcopy is done when cervical cancer screening test results show abnormal changes in the cervix cells. Colposcopy provides more information about the abnormal cells. Colposcopy also may be used to assess other problems, including further

  • genital warts on the cervix
  • cervicitis (an inflamed cervix)
  • benign (not cancer) growths, such as polyps
  • pain
  • bleeding

Sometimes colposcopy may need to be done more than once. It also can be used to check the result of treatment.

How is the procedure performed?

Colposcopy is typically done in your ob-gyn’s office.

The procedure is best done when a woman is not having her period. This gives the ob-gyn a better view of the cervix. For at least 24 hours before the test, you should not

  • douche
  • use tampons
  • use vaginal medications
  • have sex

As with a pelvic exam, you will lie on your back with your feet raised and placed on the footrests for support. A speculum will be used to hold apart the vaginal walls so that the inside of the vagina and the cervix can be seen. The colposcope is placed just outside the opening of your vagina.

A mild solution will be applied to your cervix and vagina with a cotton swab or cotton ball. This liquid makes abnormal areas on the cervix easier to see. You may feel a slight burning.

What should I expect during recovery?

If you have a colposcopy without a biopsy, you should feel fine right away. You can do the things you usually do. You may have a minor spotting for a couple of days.

If you have a colposcopy with a biopsy, you may have pain and discomfort for 1 or 2 days. Over-the-counter pain medications can be helpful. You may have some vaginal bleeding. You also may have a dark discharge for a few days. This may occur from medication used to help stop bleeding at the biopsy site. You may need to wear a sanitary pad until the discharge stops.

Your ob-gyn may suggest you limit your activity for a brief time. While the cervix heals, you will be told not to put anything into your vagina for a short time.

Cryotherapy is a freezing technique used to destroy diseased tissue.

Cryotherapy is a type of ablative treatment in which an instrument is used to freeze abnormal cervical tissue, which then sloughs off.

Loop electrosurgical excision procedure (LEEP) is a treatment to remove precancerous cells from the cervix. Removing precancerous cells helps stop them from developing into cervical cancer.

The procedure uses a small wire loop attached to an electrical current. When the loop is passed over cervical tissue, it cuts away a layer of abnormal cells. The removed tissue is sent to a lab for testing.

What happens during a LEEP?

You will lie on an exam table and place your legs in stirrups to start the procedure. Your ob-gyn will insert a speculum into your vagina in the same way as for a pelvic exam. Your ob-gyn may use a colposcope to see the cervix better.

Local anesthesia may be used to numb the cervix. Your ob-gyn also may apply a vinegar solution to the cervix to see the abnormal cells better. Application of this solution or the numbing medication may sting.

The loop is inserted through the speculum and passed over the cervix to cut away abnormal tissue. You may feel pressure, a dull ache, or a cramp. Some women feel faint during the procedure. If you feel faint, tell your ob-gyn. After the abnormal cells have been removed, a special paste may be applied to the cervix to stop bleeding.

The tissue that is removed will be sent to a lab. Your obstetrician-gynecologist (ob-gyn) should let you know the results when the testing is complete.

The procedure should be done when you do not have your menstrual period to better view the cervix. In most cases, LEEP is done in the office of an ob-gyn. The procedure takes a few minutes.

What should I expect during recovery from LEEP?

After the procedure, you may have

  • a watery, pinkish discharge
  • mild cramping
  • a brownish-black discharge (from the paste used)

It will take a few weeks for your cervix to heal. While your cervix heals, you should not place anything in the vagina, such as tampons or douches. You should not have sexual intercourse. Your ob-gyn should tell you when it is safe to do so.

You should contact your ob-gyn if you have any of the following problems:

  • Heavy bleeding (more than your normal period)
  • Bleeding with clots
  • Severe abdominal pain

A procedure in which a small amount of the tissue lining the uterus is removed and examined under a microscope.

Hysteroscopy is used to diagnose or treat problems in the uterus. A hysteroscope is a thin, lighted telescope-like device. It is inserted through your vagina into your uterus. The hysteroscope transmits the image of your uterus onto a screen. Other instruments are used along with the hysteroscope for treatment.

Why is hysteroscopy done?

One of the most common uses for hysteroscopy is to find the cause of abnormal uterine bleeding. Abnormal bleeding can mean that a woman’s menstrual periods are heavier or longer than usual or occur less or more frequently. Bleeding between menstrual periods also is abnormal (see FAQ095 Abnormal Uterine Bleeding). In some cases, abnormal bleeding may be caused by benign (not cancer) growths in the uterus, such as fibroids or polyps.

Hysteroscopy also is used in the following situations:

  • Remove adhesions that may occur because of infection or from past surgery
  • Diagnose the cause of repeated miscarriage when a woman has more than two miscarriages in a row
  • Locate an intrauterine device (IUD)
  • Perform sterilization, in which the hysteroscope is used to place small implants into a woman’s fallopian tubes as a permanent form of birth control

How is hysteroscopy performed?

Before the procedure begins, you may be given a medication to help you relax, or a general or local anesthetic may be used to block the pain. If you have general anesthesia, you will not be awake during the procedure.

Hysteroscopy can be done in a health care professional’s office or at the hospital. It will be scheduled when you are not having your menstrual period. To make the procedure easier, your health care professional may dilate (open) your cervix before your hysteroscopy. You may be given medication inserted into the cervix, or special dilators may be used. A speculum is first inserted into the vagina. The hysteroscope is then inserted and gently moved through the cervix into your uterus. Carbon dioxide gas or a fluid, such as saline (saltwater), will be put through the hysteroscope into your uterus to expand it. The gas or fluid helps your health care professional see the lining more clearly. The amount of fluid used is carefully checked throughout the procedure. Your health care professional can view the lining of your uterus and the openings of the fallopian tubes by looking through the hysteroscope. Small tools will be passed through the hysteroscope if a biopsy or other procedure is done.

What should I expect during recovery?

You should be able to go home shortly after the procedure. If you had general anesthesia, you might need to wait until its effects have worn off.

It is normal to have mild cramping or a little bloody discharge for a few days after the procedure. You may be given medication to help ease the pain. If you have a fever, chills, or heavy bleeding, call your health care professional right away.

Ultrasound is energy in the form of sound waves. During an ultrasound exam, a transducer sends sound waves through the body. The sound waves contact tissues, body fluids, and bones. The waves then bounce back like echoes. The transducer receives these echoes, which are turned into images. The images can be viewed as pictures on a video screen.

How is ultrasound used in women’s health care?

Ultrasound is used to diagnose and monitor medical conditions unrelated to pregnancy. It is used to create images of the pelvic organs to find or diagnose problems. Some of how ultrasound may be used include the following:

  • Evaluate a mass in the pelvis (such as an ovarian cyst or a uterine fibroid)
  • Look for possible causes of pelvic pain
  • Look for causes of abnormal uterine bleeding or other menstrual problems
  • Locate an intrauterine device (IUD)
  • Diagnose reasons for infertility
  • Monitor infertility treatments

In addition, ultrasound may assess unclear mammography findings, help guide breast biopsy procedures, and evaluate breast lumps.

How is ultrasound used during pregnancy?

Ultrasound is used to view the fetus inside the uterus. It allows your obstetrician-gynecologist (ob-gyn) or other health care professional to check the fetus’s health and development, monitor your pregnancy, and detect many congenital anomalies. Ultrasound also is used during chorionic villus sampling and amniocentesis to help guide these procedures. There are three types of prenatal ultrasound exams: 1) standard, 2) limited, and 3) specialized.

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