Hysterectomy - The surgical removal of part or all of the uterus. Surgical options offer varying degrees of invasiveness:

• Abdominal hysterectomy - An incision is made through the skin and tissue of the lower abdomen to reach the uterus and ovaries. This is sometimes the only option for surgery.
• Vaginal hysterectomy - Surgery is done through the vagina. With no external incision, recovery time is generally shorter than with abdominal surgery.
• Laparoscopic hysterectomy - Surgery is done through small incisions in the abdomen while the surgeon views the pelvic organs on a screen via the light-transmitting laparoscope. Recovery time is generally shorter than that of a vaginal hysterectomy.
• da Vinci® robot-assisted hysterectomy - Surgery is done through small incisions in the abdomen with flexible instruments controlled remotely by the surgeon, who has enhanced visualization of the pelvic organs via a 3-D monitor. This minimally invasive procedure requires the shortest hospital stay - many patients go home the next day.

Hysteroscopy - A way to look inside the uterus with a thin, telescope-like device that is inserted through the vagina and cervix. The hysteroscope may help the physician diagnose (diagnostic hysteroscopy) or treat (operative hysteroscopy) a uterine problem.

Myomectomy - Surgical removal of uterine fibroids (myomas). Like some other gynecological care, it may be done as an abdominal, hysteroscopic, laparoscopic or robot-assisted procedure.

Endometrial ablation - Treatment of the lining of the uterus (endometrium) to control or stop excess menstrual bleeding. During the procedure, a thin layer of the endometrium is destroyed with an electrical, laser or thermal energy source.

D &C (dilation and curettage) - A procedure by which a sample of the lining of the uterus (endometrium) is taken for examination and used to diagnose or treat many conditions that cause abnormal uterine bleeding. It also can be used to help detect cancer of the uterus.

Treatment of abnormal pap smears - When abnormal cervical cells are detected by a Pap smear or other screening test for cervical cancer or precancerous abnormalities, further evaluation and treatment are necessary. The following procedures are options:

• Cervical cone biopsy - A surgical procedure in which a small, cone-shaped portion of the cervix is removed to evaluate the abnormality for treatment. The cone biopsy itself might remove all of the suspicious cells, if they are located in the biopsy area.
• LEEP (loop electrosurgical excision procedure) - A procedure in which a thin wire loop acts as a surgical knife when an electrical current passes through it. The loop cuts away a thin layer of abnormal surface cells, exposing new, healthy cells.

Endometriosis treatment - Endometriosis is the growth of tissue, elsewhere in the body, like that which normally lines the uterus (endometrium). It can be painful and may affect fertility. Treatment includes the following:

• Laparoscopic surgery - Surgery through small incisions in the abdomen removes or destroys endometriosis lesions and may restore fertility.
• Abdominal surgery - If the endometriosis is more extensive, a laparotomy may be required. This procedure requires a larger incision and longer recovery time than a laparoscopy. In the most severe cases, a hysterectomy with bilateral salpingo-oophorectomy (removal of the uterus, fallopian tubes and ovaries) may be done to remove all visible areas of endometriosis.

Evaluation of pelvic mass - In order to distinguish between normal pelvic organs and an enlargement that might represent an abnormality or malignancy, abdominal, laparoscopic or robot-assisted surgery may be performed. Minimally invasive surgery with the da Vinci Robot Surgical System allows the surgeon precise control of remotely operated flexible instruments while visualizing the pelvic organs via a 3-D monitor.

Laser for condyloma (genital warts) or abnormal vaginal/cervical lesions - Laser surgery may be used when surgical excision is not possible or would be difficult. A laser destroys tissue by focusing a precisely controlled beam of intense light on the condyloma or lesions. As water in the tissue absorbs the light energy, the tissue is destroyed.

Pelvic support procedures - Pregnancy and childbirth may weaken connective tissue and muscles that hold the pelvic organs in place. Procedures to improve this condition include the following:

• Anterior/posterior repairs - Surgery to repair an anterior wall prolapse (or cystocele - occurs when the bladder drops from its normal place into the vagina) or posterior wall prolapse (or rectocele - occurs when the rectum drops into the vagina).
• Sacral colpopexy and mesh placement - Surgery to repair a vaginal vault prolapse (the upper part of the vagina falls in on itself), which may occur after a hysterectomy. The vagina is attached to the sacrum (tailbone) via a piece of mesh that acts like a bridge.
• Sling - A device that treats stress urinary incontinence associated with an anterior wall prolapse (cystocele) by elevating the urethra and bladder.

Urogynecologic procedures - Surgery to treat stress incontinence that may occur with physical activities that increase abdominal pressure, like sneezing, coughing, laughing or lifting heavy objects. Procedures include the following:

• Sling - Surgery to insert a device, either synthetic or of the patient's own tissue, that elevates the urethra and bladder to treat stress incontinence.
• TVT (tension-free transvaginal tape) sling - Surgery to insert an adjustable device that may be customized - during surgery - to the patient's individual needs.
• TOT (transobturator tape) sling - Surgery through a groin incision that provides support for the urethra via mesh tape.