What is Minimally Invasive Gynecologic Surgery (MIGS)-

What is MIGS?

Minimally Invasive Gynecologic Surgery (MIGS) replaces the use of large incisions into the abdomen with smaller incisions (or in some cases, no incisions), which allow the surgeon to view the inside of the body with a small camera and manipulate the internal organs with small surgical tools. Surgeons work together to perform a minimally invasive gynecologic surgical procedure, a technique that has been shown to lessen pain and shorten recovery time.

Gynecologists trained in minimally invasive gynecologic surgery specialize in evaluating and treating people who have a wide range of noncancerous (benign) gynecologic conditions, including heavy menstrual periods (menorrhagia), irregular menstrual periods (metrorrhagia), pelvic pain, endometriosis and ovarian cysts. Your care is provided either in the exam room or an outpatient surgical suite. A minimally invasive approach has been shown to improve outcomes and reduce discomfort, inconvenience and expense.

By taking this minimally-invasive approach, surgeons have been able to reduce the pain and blood loss associate with surgery, allowing patients to resume their normal routine 1-2 weeks instead of after more than a month as is the case with “open” surgeries.

MIGS- FPD (Focus Practice Designation)

The focused practice designation in minimally invasive gynecologic surgery (MIGS) provides ABOG (Amercan Board of OBGYN)  the opportunity to establish standards and assessments for this surgical technique within the field of obstetrics and gynecology. It also allows ABOG to recognize those Diplomates who have additional surgical expertise and dedicate a significant percentage of their practice to the care of women with benign and complex gynecologic diseases and manage complications using minimally invasive surgical techniques. Additionally, the focused practice designation will provide those Diplomates with special interest in minimally invasive gynecologic surgery a more focused, relevant, and pertinent continuous professional development.  Dr. Quezada is the ONLY MIGS-FPD surgeon in Longview or East Texas. 

Latest Advances in Gynecologic Minimally Invasive Surgery-Innovative treatment options

Dr Quezada will talk with you about a range of innovative treatment options and develop an individualized treatment plan that might involve one of these minimally invasive gynecologic approaches:

  • Hysteroscopic surgery. This technique does not require any incisions and has minimal recovery time.  Hysteroscopic Surgery allows the surgeon to enter the body without any incision, most commonly through the vagina. In the case of hysteroscopy, the surgeon will thread a small camera and light through the vagina and cervix to view the inside of the uterus. Depending on the type of surgery, the surgeon may also thread other tools through the opening in order to complete the procedure.
  • Advanced laparoscopic surgery. This type of surgery involves the use of 1-5 small incisions on the abdomen, through which tiny cameras, lights, and surgical tools are threaded by way of an entry “port” called a trocar to access the surgical site.  In laparoscopic surgery, the surgeon views the inside of the abdomen on a video screen in the operating room while also manipulating surgical tools like graspers and scissors from outside of the abdomen. In some cases, laparoscopic surgery may involve the use of a robot, in which case the surgeon sits at a video station near the patient and manipulates surgical tools that are connected to the arms of the robot remotely.

    This technique has been shown to be an effective treatment that results in shorter hospital stays, less discomfort and a shorter recovery period. Laparoscopic radiofrequency ablation is a less invasive alternative to hysterectomy and myomectomy. It involves no cutting of the uterine tissue, and most women are typically back to normal activity within seven days.
  • Robotic-Assisted Laparoscopic Surgery. This approach has the same advantages as advanced laparoscopy, and it allows surgeons to operate with increased precision and accuracy while minimizing trauma to surrounding tissues.  The surgeon uses a robotic system with a console that provides magnified, high-resolution 3D imaging of the surgical site, and controls arms with miniaturized instruments to perform a laparoscopy.
  • Vaginal surgery. This is the most minimally invasive approach to major gynecologic surgery. It has all of the recovery advantages associated with laparoscopic and robotic surgery, while also avoiding any abdominal incisions.
  • Laparoscopic-assisted vaginal technique: The surgeon accesses the surgical site using both laparoscopy and the vaginal approach.  This includes the innovate vNOTES (Vaginal Natural Orifice Trans-Endoscopic Surgery)
  • Single port surgery: The surgeon performs laparoscopy with just one incision into the navel (belly button).


Benefits of Gynecologic Minimally Invasive Surgery

Minimally invasive techniques offer a safer and effective alternative to traditional open surgery by avoiding a large abdominal incision. With minimally invasive gynecologic surgery, our patients can have:

  • Smaller incisions
  • Less blood loss
  • Less pain
  • Shorter hospital stays
  • Faster recovery and return to daily activities
  • Reduced scar tissue
  • Less risk of infection or other complications

Conditions We Treat with Gynecologic Minimally Invasive Surgery

Whenever possible, we use minimally invasive gynecologic techniques, rather than open surgery. Our gynecologic surgeons have expertise in minimally invasive techniques to treat a wide range of gynecologic conditions, such as:

  • Ectopic pregnancy
  • Heavy bleeding and painful periods
  • Pelvic inflammatory disease
  • Pelvic adhesions (painful scar tissue)
  • Pelvic pain
  • Postmenopausal bleeding
  • Uterine fibroids (Acessa ablation, myomectomy)
  • Uterine polyps
  • Cancer staging: Evaluation of cancerous tissue to determine whether it is in an early or a late stage, to help plan treatment
  • Endometrial ablation: Procedure to destroy the endometrium to reduce heavy menstrual bleeding
  • Hysterectomy: Removal of the uterus and, in some cases, the ovaries and fallopian tubes
  • Myomectomy: Removal of uterine fibroids and reconstruction of the uterus
  • Ovarian cystectomy: Removal of ovarian cysts
  • Resection and treatment of endometriosis: Removal of endometriotic implants and scar tissue with restoration of anatomy and functioning of organs
  • Pelvic organ prolapse repair: Suspension or reattachment procedures to reposition prolapsed pelvic organs, such as in the case of a cystocele (bladder hernia) or rectocele (rectal hernia), back into their proper positions
  • Cancer surgery: Removal of cancerous tumors from the cervix, uterus, ovaries, and other reproductive organs
  • Tubal ligation: Sterilization by cutting or blocking the fallopian tubes to permanently prevent pregnancy
  • Tubal reanastomosis: Procedure to reverse a tubal ligation by reconnecting the fallopian tubes
  • Family Planning surgery- sterilization